The irrational use of antibiotics is increasing in Jordanian refugee camps and consequently so too is bacterial resistance. About one-third of health expenditures at UNRWA health centers in Jordan are attributed to antibiotics. Objective: We studied knowledge, attitude and behaviour of Palestine refugees attending UNRWA health centers in Jordan regarding antibiotic use in order to plan public health interventions accordingly. Methods: A cross-sectional, interviewer-administered survey among 250 adult Palestine refugees at four different health centers was conducted. Results: Irrational antibiotic use was widespread: 63% of patients share antibiotics at home, 38% use left-over antibiotics and 60% purchase antibiotics directly from the pharmacy without prescription (OTC).1 At the same time, knowledge about antibiotics side effects, resistance, and target agent was low. 90% of patients trust their doctor, however long waiting hours prevent them from seeking medical advice, which significantly increased self-medication. Conclusions: Our findings suggest a strong need for public education about antibiotics. In addition, health institutional level improvements such as shorter waiting hours and strict regulations prohibiting dispensing without prescription are necessary to combat growing bacterial resistance. © 2018 Elsevier Ltd

Access to health services Resistance Behaviour patterns Antibiotics palestine refugees

education refugee Jordan health care personnel human Refugees antibiotic agent statistics and numerical data United Nations Arab Arabs knowledge Cross-Sectional Studies prescription cross-sectional study Humans attitude male female risk factor Risk Factors Behavior questionnaire self medication prevalence Health Knowledge, Attitudes, Practice standards Article major clinical study adult non prescription drug physician health care quality drug use antibiotic resistance health care system antiinfective agent Drug Resistance, Bacterial Anti-Bacterial Agents pharmacist attitude to health Health Services Accessibility primary health care health care delivery