Academic journal article Central European Journal of Public Health

Antibiotics in Serbian Households: A Source of Potential Health and Environmental Threats?

Academic journal article Central European Journal of Public Health

Antibiotics in Serbian Households: A Source of Potential Health and Environmental Threats?

Article excerpt


Recent analysis has shown that Serbia belongs to countries with high consumption of antibiotics (1,2). The Republic of Serbia is a South Eastern European country in socioeconomic transition and in the process of harmonization with health laws of the European Union. Serbia has been an independent state since 2004 and is one of the few countries in Europe which has not joined the European Surveillance of Antimicrobial Consumption (ESAC) project yet.

Worldwide data indicate that antibiotics are frequently used inappropriately (3). This inappropriate use may contribute to antibiotic resistance, which is reaching alarming levels in Southern and Eastern Europe (4). Disregarding the problem of antibiotic resistance leads not only to unfavourable medical consequences, but also to substantial ecological and economic consequences (5-8).

A limited number of surveys have been conducted around the world to explore the extent of antibiotic storage in households. The study conducted in Spain showed that the storage of antibiotics in households is an important factor which increases the cost, reduces the efficiency and decreases the quality of antibiotic treatment at the community level (9). Similar studies earned out in Russia and Palestine indicated that antibiotics were widely stocked among the general population and often used for self-medication (10,11).

Level of antibiotics storage and wastage in households is a topic of great interest and such study has not been carried out in Serbia. Therefore, the objective of this study was to investigate to what extent antimicrobials are stored and wasted in a sample of households in Novi Sad.


This is an observational, cross-sectional study of the characteristics of storage and wastage of antibacterial agents in households in the city of Novi Sad, Serbia. To the best of our knowledge, this is the first study of this type in Serbia. The study protocol was approved by the Ethical Committee of the Faculty of Medicine in Novi Sad. The study was performed in eight months period (December 2011-July 2012) and involved a sample of383 households in Novi Sad. Sample size was calculated according to results of a pilot study researching self-medication conducted in 2010 in 191 households in Novi Sad, Serbia, where percentage of drugs that were bought without prescription or consultation with physician was 46.8%. Based on this result, a sample size necessary to estimate the proportion of drugs bought without prescription with 95% confidence interval and 5% precision was 383 households.

The White Pages telephone directory with listing of noncommercial telephone subscribers was used for sampling. Systematic random sampling was performed by choosing the first number by random and dialing every 30th until the sample of 383 households willing to cooperate was reached. In total, 1,008 households were contacted (response rate 38.0%). According to 2011 Census of population, households and dwellings in the Republic of Serbia, the number of households in Novi Sad is 115 294, thus our sample include 0.33% of households. The survey was performed in Serbian language by a trained interviewer who informed the respondents about the aim of the study and asked for permission to visit them at home. Only the families willing to cooperate were included in this study. The respondents were Serbian speaking adults (> 18 years of age) responsible for the home medicine cabinets. If the right person was not available, the interview was performed with another randomly selected Serbian-speaking adult in the household.

The study consisted of a personal insight into the inventory of drugs and antibiotics in households and interview. Questionnaire was pre-tested on a small sample of households to ensure satisfactory validity and clarity. The questions were of varied format: checklists and closed-ended questions. The first part of the questionnaire focused on questions about age of the interviewee, educational level of the interviewee, number of family members and their ages, presence of any family member with a chronic disease, and presence of any family member with an acute disease (in the last two weeks). …

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