use of medicines in Oman: public knowledge, attitudes and practices

The objective of this study was to identify the common problems of medicine use in Oman in order to improve the appropriate use of medicines. A cross-sectional, pilot-tested questionnaire was administered to 6,675 Omani patients or their carers on exit from primary health care centres. 66% of respondents visited multiple facilities on the same date for the same complaint and 51% failed to go for follow up to the same facility. 39% did not accept non-drug therapy and 30% preferred prescription of 3 or more medicines per visit. Many failed to ask how or when to take the medicines, where to store them at home and did not mention any current therapies they were taking. A total of 70% stopped taking their medicines when symptoms disappeared; 26% were unaware that most medicines have side-effects and 61% did not realise that injections are the riskiest dosage form. A total of 54% had definite colour and taste preferences; 43% practised self-medication and 68% never consulted the dispenser; 36% chose medicines based on previous experience and 33% exchanged medicines with others; 55% stored all their medicines in a fridge and 17% did not check the expiry date; 45% threw unused medicines away; 41% kept them for future use and only 12% returned them to a pharmacy or health facility. There is a widespread lack of knowledge about the appropriate use of medicines in Oman. Certain attitudes and beliefs can contribute to health risks and unnecessary expenditure. Many of these results could be improved by a well-targeted public education campaign

investigation into perioperative antibiotic use during lower segment caesarean sections [LSCS] in four hospitals in Oman

This investigation aims to assess the current practice of antibiotic prophylaxis and its use in various types of surgery in Oman. A retrospective sample of 510 patients from four major hospitals were studied for the use of antibiotics in lower segment caesarean section [LSCS] surgeries. There was a great diversity in the regimes from each hospital and only one had written guidelines. Although cephalosporin was used in the majority of cases, there was little consistency in the generation prescribed with second generation cefuroxime being the most popular [47% of all cases]. The majority of cases also had metronidazole added. In one hospital, ampicillin was the prophylactic of choice and was routinely combined with oral amoxicillin. There were very few cases where only a single dose was given with most receiving at least 3 doses. In one extreme case, most patients received five days of prophylaxis with a 3rd gen-eration cephalosporin. It appears that protocols for antibiotic prophylaxis have developed in an ad hoc fashion over time. It was found that none of the studied hospitals followed the Ministry of Health antibiotic guidelines, nor were they using any international standard or recommendation. Based on the available infection rates, a consistent policy with written guidelines appears to lead to the best outcomes for patients