A systematic review conducted in the Middle East, by Alhomoud et al., reported that self-medication with antibiotics was high in Saudi Arabia and ranged from 48 to 79%. Thus, self-medication – and irrational antibiotic dispensing and prescribing – is causing a major concern to the public health sector and Ministry of Health (MoH) in Saudi Arabia. In Saudi Arabia, the rates of both antibiotic consumption and resistance are amongst the highest in the Middle Eastern countries. Others dispensed antibiotics without a clear clinical indication and without carrying out any patient counselling. Although dispensing antibiotics without a prescription has been illegal for pharmacists for more than three decades in Saudi Arabia, studies revealed that over half of the pharmacists dispensed antibiotics without prescription to treat cold, cough, sore throat and other viral infections. Studies in Saudi Arabia reported that non-prescribed sale of antibiotics was high in community pharmacies and ranged from 63 to 82%. Self-medication includes the use of medicines by the consumer to treat self-recognised symptoms or disorders without proper medical consultation. In Saudi Arabia, the availability of antibiotics over-the-counter, without medical prescriptions, is a major contributing factor towards self-medication behaviour among the general population. A review estimated that, by 2050, antimicrobial drug resistance (AMR) would lead to 10 million people dying every year unless the problem of AMR is tackled by a global response. It was estimated that 23,000 deaths and more than 2 million illnesses were caused by antibiotic resistance.
![antibiotics over the counter antibiotics over the counter](https://img.theweek.in/content/dam/week/webworld/feature/lifestyle/2017/june/medicines.jpg)
Even though antibiotics represent a vital public health achievement, their overuse and misuse, as a result of irrational prescribing and dispensing and self-medication, may cause serious adverse events, recurrent infections, antibiotic resistance, and increased treatment cost and poor health outcomes.