THE EVALUATION OF RATIONAL USE OF SOME DRUGS IN ALBANIA
Objective: The irrational use of medicines is a major problem worldwide. The irrational antibiotics are one of the causes of mortality and morbidity
around the world and the increasing of antimicrobial resistance too. The objective is to study the consumption of some reimbursement drugs, the
study of consumption of main antibiotics in a few pharmacies in Tirana, Albania and at the same time, to study the knowledge of the random antibiotic
use of patients in Tirana.
Methods: Part I. There are five pharmacies randomly selected in Tirana, which are part this study. They accepted us to have access to a considerable
number (2910) of reimbursement prescriptions, consumed in a total of 5 months. The medical prescriptions were analyzed for: (1) The average total
number of drugs prescribed; (2) The percentage of drug prescribed with the right generic name; (3) The percentage of antibiotics prescribed; (4) The
percentage of injectable pharmaceutical forms prescribed; (5) The average cost of every reimbursement prescription. Part II. There are taken into
consideration ten pharmacies located in the city of Tirana. The consumption and the knowledge of the patients about antibiotics were analyzed. The
data are collected for a single month (May 2014). We took into consideration the entries of antibiotics and antimicrobials subtracting the present
stock of these drugs.
Results: As we see from the results in there are 91.6% of reimbursement prescription prescribed in accordance with low Albanian Drug Regulation.
The average number of drugs prescription is about 2 which means we have not overprescribed of drugs in reimbursement ones. The average of
the percentage of injectable forms is 3.18, which is not very high too. Azithromycin has the highest consume, followed by amoxicillin, and the
chloramphenicol has the lowest one. A high number of patients interviewed (in total 148 or 59.2%) are answered that they take antibiotics only with
a medical prescription, and there were not a significant difference between female and males.
Conclusions: The findings of this study suggest that the drugs given in reimbursement prescription are generally in accordance with diagnosis and
rational prescription. Further investigation is needed to analyze non-reimbursement prescription which do not have the some monitoring system
which means that may have more problems that reimbursement ones. The authorities must have under control the enforcement of regulation low for
drug purchasing process. On the other hand, we should sensibilize all the age groups to avoid self-medication especially with antibiotics which cause
the resistance problems. The doctors should be careful not to prescribe the drugs by trade name respecting the proper protocols.
[Last accessed on 2012 Jan 14].
2. Mnyika KS, Killewo JZ. Irrational drug use in Tanzania. Health Policy
3. Patel V, Vaidya R, Naik D, Borker P. Irrational drug use in India:
A prescription survey from Goa. J Postgrad Med 2005;51(1):9-12.
4. Kastury N, Singh S, Ansari KU. An audit of prescription for rational use
of fixed dose ombinations. Indian J Pharmacol 1999;31(5):367e-9.
5. Calva J, Bojalil R. Antibiotic use in a periurban community in Mexico:
A household and drugstore survey. Soc Sci Med 1996;42(8):1121-8.
6. Arustiyono, Apt. Promoting Rational use of Drugs at the Community
Health Centers in Indonesia, [Dissertation]. Boston: Department of
International Health, School of Public Health, Boston University; 1999.
7. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions
in hospitalized patients: A meta-analysis of prospective studies. JAMA
8. Hitchen L. Adverse drug reactions result in 250,000 UK admissions a
year. BMJ 2006;332(7550):1109.
9. Mathur AG. Outpatient Prescription Patterns in a Tertiary Level Service
Hospital. New Delhi: Proceedings of the XVI Asia Pacific Military
Medicine Conference; 1996.
10. Adebayo ET, Hussain NA. Pattern of prescription drug use in Nigerian
army hospitals. Ann Afr Med 2010;9(3):152-8.
11. Institute of Medicine. Microbial Threats to Health: Emergence,
Detection and Response. Washington, D.C: Nationa12.
12. Simonsen L, Kane A, Lloyd J, Zaffran M, Kane M. Unsafe injections
in the developing world and transmission of bloodborne pathogens:
A review. Bull World Health Organ 1999;77(10):789-800.
13. Livermore DM. Bacterial resistance: Origins, epidemiology, and
impact. Clin Infect Dis 2003 15;36 Suppl 1:S11-23.
14. Levy SB. Antibiotic resistance-the problem intensifies. Adv Drug Deliv
15. Harbarth S, Samore MH. Antimicrobial resistance determinants and
future control. Emerg Infect Dis 2005;11(6):794-801.
16. Kaplan W, Laing R. Priority medicines for Europe and the world.
Geneva: World Health Organization; 2004. Available from: http://
17. Lansang M, Lucas-Aquino R, Tupasi TE, Mina VS, Salazar LS,
Juban N, et al. Purchase of antibiotics without prescription in Manila,
the Philippines: Inappropriate choices and doses. J Clin Epidemiol
1990;43(1):61-7. Van der Geest S, Hardon A. Self-medication in
developing countries. J Soc Adm Pharm 1990;7(4):199-204.
18. WHO. How to investigate drug use in health facilities: Selected drug
used indicator. The World Medicines Situation 20. Geneva, Switzerland:
Academies Press; 1998.
19. Obaseiki-Ebor EE, Akerele JO, Ebea PO. A survey of antibiotic
outpatient prescribing and antibiotic self-medication. J Antimicrob
20. Rajanandh MG, Ramasamy C, Khan AI. Pattern of cardiovascular
drugs use in outpatients in a tertiary care hospital. Asian J Pharm Clin
21. Grigoryan L. Self-Medication with Antibiotics in Europe and its
Determinants. Dissertation. Netherlands: Groningen University; 2007.
22. Verhoef J, Fluit AC, Jansen W, van der Bruggen JT. Resistance:
A sensitive issue. The European Roadmap to Combat Antimicrobial
Resistance. Utrecht: The Strategic Council on Resistance in
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