Perspectives on the Concurrent Use of Traditional and Prescribed Antimicrobial Medicines for Infectious Diseases: A Triangulation Study in a South African Community

Abstract

Traditional medicines are generally available, affordable and commonly used as self-care treatments. However, their inaccurate 
utilization can results in adverse events, or unfavourable outcomes. Individuals may consult both traditional healer practitioners 
(THPs) and biomedically trained healthcare professionals (BHPs) for their infections. This study aimed at determining whether
any antimicrobial resistance and treatment failure could occur among patients, attending outpatient departments of selected 
healthcare facilities, who used concurrently prescribed antimicrobial and traditional medicines. A survey was conducted to assess
the perceptions, knowledges, attitudes and beliefs of respondents on the concurrent use of traditional and prescribed medicines 
for infections. 132 respondents were included namely THPs, THP’s patients, BHPs and BHP’s outpatients. A small number of 
medicinal plants were used in the treatment of infections and 65.62% of both THPs and their patients (21/32) reported mixing 
different herbs for the treatment of infections. Respondents agreed that the combination of traditional and prescribed medicines 
for infections may lead to interactions, adverse effects; infectious diseases may get worse if there is no time lapses between the 
two medicines. However, BHPs and outpatients reported that combining traditional with prescribed medicines for infectious 
diseases may result in drug resistance, especially resistance to antibiotics and they highlighted that the majority of patients came 
to the clinic with several complications such as kidney failure, vomiting, diarrhea and jaundice due to the use of traditional 
medicine either alone or in combination with conventional medicines. The concurrent use of conventional and traditional herbal 
medicines may interfere or result in damaging some organs, failure of therapeutic effects and modification of pharmacological
actions of administered medicines.