Evaluation of concomitant use of prescribed antimicrobial medicines with traditional medicines in iLembe District, South Africa: A medical chart review

Abstract

Abstract
Background: Antimicrobial resistance in South Africa is driven by many factors, such as the careless use of prescribed antimicrobial medicines and the use of traditional medicines, with the result that there is always the danger of misadministration, interaction, and toxicity. This study was conducted in two different public healthcare facilities in iLembe District, KwaZulu-Natal Province, South Africa to determine whether any interaction occurred among patients attending outpatient departments in selected healthcare facilities in terms of the concurrent use of traditional medicines and prescribed antimicrobial medicines.

Methods: This study was a cross-sectional descriptive study using medical chart reviews. Antimicrobials prescribed alone or in association with traditional medicines were assessed and reported using descriptive statistics. Where applicable, associations were carried out; a p-value ˂0.05 was estimated as statistically significant.

Results: A total of 400 outpatients’ medical records were documented from two different municipalities, revealing that many participants had viral infections (194/400, 48.5%). Overall, 12% of participants (48/400) had documented adverse effects (30/48) and interactions (18/48). A few participants (15/400) used traditional medicines in conjunction with prescribed medicines. After adjustment, negative clinical outcomes namely adverse effects and interactions were significantly more likely due to the use of traditional medicines (AOR=0.01, 95% CI:0.001-0.05) and (AOR=0.21, 95% CI: 0.37-1.23), respectively.

Conclusions: Traditional medicine was used sparingly in conjunction with prescribed antimicrobials for infectious diseases. However, adverse effects and interactions, such as herbal intoxication, persistent rashes, and treatment failure, were documented in a few medical records. Further studies are needed to investigate the effects of the concurrent use of traditional medicine with antimicrobials or other prescribed medicines from the perspectives of traditional healers and biomedically healthcare professionals. [Ethiop. J. Health Dev. 2021; 35(1):58-71]

Key words: Concomitant use, prescribed antimicrobials, traditional medicine, antimicrobial resistance, treatment failure, adverse effects