Publications

Background Antimicrobial Resistance (AMR) is a major global concern. Irrational use of antibiotics including self-medication (SM) with leftovers without a medical prescription can be a leading cause. This study aimed to investigate the prevalence and related factors of leftover antibiotics (LA) in Lebanese households. Study design A cross-sectional study of the Lebanese population was conducted between March and October 2022. Methods Through random proportional stratified sampling, a total of 494 families participated in this study. Data collection was carried out through phone calls using a comprehensive and reviewed questionnaire. The data was then analyzed using SPSS version 26. Logistic regression was utilized to identify the factors associated with LA, with the presence of LA in households as the dependent variable and other factors such as age, region of residence, and presence of elderly individuals at home as the independent variables. Results Among selected households, 118 households (23.89%) had LA. The most common type of antibiotic found was penicillin (59.84%). Most of the LA were in the form of tablets and capsules (94%) with valid expiration dates (87%). Antibiotics were mainly prescribed by doctors (61%), and the main reason for prescribing was acute respiratory tract infections (47.46%). SM was reported by 42.37% of the families with LA. A family with elderly patients (p = 0.002; OR = 2.23; 95% CI = 1.33–3.73) and those residing in Mount Lebanon (p = 0.019; OR = 2.28; 95% CI = 1.14–4.56) had significantly higher odds of having LA. Conclusion Leftover antibiotics were found in nearly a quarter of the addressed Lebanese families. Therefore, public educational campaigns should be launched to limit injudicious antibiotic use including SM, and to promote proper disposal of any leftovers. It is also crucial to adopt the One Health approach by developing national programs for the safe disposal of LA and implementing regulations to restrict the distribution of antibiotics in pharmacies without a prescription. Keywords AntibioticsLeftoversPrevalenceLebanonHouseholdsSelf-medication Advances in knowledge LA are a critical aspect of SM without medical supervision, which is a potential risk of AMR. However, limited evidence is available related to LA in the community and the factors associated with them. This is the First study in Lebanon tackling this issue and shedding a light on the drastic sequences of this problem. Implications for policy and practice • Education programs aimed at promoting the rational use of antibiotics and emphasizing the importance of adhering to the prescribed regimen should be actively encouraged. These programs should target healthcare personnel, particularly physicians, as well as community members. • Enforcing regulations on the dispensing of non-prescription antibiotics is imperative. • Urgent action is needed to develop and implement national programs that promote the safe disposal of LA. • In Lebanon, pharmacists should strictly adhere to the professional practice of not dispensing antibiotics without a valid medical prescription.