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54 Primary health care education and antibiotics overuse
  1. Nawras Azzam
  1. MOH, Huraymila, Saudi Arabia


My name is Nawras Azzam, I am an ENT specialist currently working in Saudi Arabia for the past 3 years as the head of emergency department which has a capacity of 100 beds. I am originally from Syria in the Middle East.

Over the counter Antibiotic and its overuse has been discussed before in different parts of the world and some countries were able to control its use by making it illegal to give antibiotic to patients without a doctor’s prescription. However, Saudi Arabic is still one of many countries that still faces the issue of over the counter abuse of antibiotic.

The case study that was contacted regarding URTI and febrile patients showed that 50%–60% of these patients who were surveyed received anti-microbial therapy. The source of medicine was from PHCs, private hospital and pharmacies.’ The medication was provided by PHCs, private hospitals and pharmacies’

This uncontrolled prescribing of antibiotics has led to wrong diagnosis, wrong use, over use, and unsuspected bacterial resistance of antibiotics.

When faced with a patient of medical history, I found myself in a dilemma. Questioning myself if I should start from the beginning or continue with more investigation to confirm the diagnosis?

According to a study that was conducted in Saudi Arabic, the conclusion was as follows:

What is required is correct identification of the illness and good diagnosis methods if needed. In addition, primary health care education is the cornerstone of avoiding over diagnosis and over use of antibiotics.

MOH in Saudi Arabia introduced a new intuitive to stop the use and purchase of antibiotics without a prescription and has required a swab and culture for some specific antibiotics related to 3rd and 4th generations.

Furthermore, we have started educational programs in the high schools and Social institutions by giving lectures regarding antibiotics use, the differences between viral and bacterial infection and when to use anti microbial therapy.

Around 40%–50% of patients have received our new guidelines. The feedback was very positive. They were very satisfied with the outcome. They were pleased to understand their kids who get infected with URTI or only suffering of fever.

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