Antibiotics self-medication practices among health care professionals in selected public hospitals of Addis Ababa, Ethiopia

The global prevalence of antibiotic self-medication among the adult population: systematic review and meta-analysis

BACKGROUND

Antibiotic self-medication (ASM) is when a person takes antibiotics without a prescription or consulting a healthcare professional. These practices contribute to the misuse of medicines and antibiotic resistance which is a growing global health threat that can lead to longer hospital stays, higher healthcare costs, and increased mortality rates. Though various studies have been conducted on ASM in different countries, there has not yet been a systematic review that comprehensively assesses the problem in the entire globe. Hence, this systematic review and meta-analysis aimed to evaluate the global pooled prevalence of antibiotic self-medication and the reasons for its practice.

METHOD

A systematic search of electronic registers and databases was conducted on PubMed, Medline, Embase, Scopus, Web of Science, Google Scholar, and gray literature including institutional repositories, and national health databases. It used carefully selected keywords and indexing terms in the past ten years. The Joanna Briggs Institute's critical checklist extracted relevant data after appraisal. Narrative analysis was used for descriptive data while Comprehensive Meta-Analysis (CMA) Software was used to analyze quantitative data. Statistics were used to look for heterogeneity, publication bias, and correlations. Sensitivity tests and sub-group analysis were employed to compare outcomes. A p-value < 0.05 was considered significant in all cases.

RESULTS

Seventy-one studies were included in this systematic review and meta-analysis. The total number of participants was 63,251 with sample sizes ranging from 110 to 15,526. In primary outcomes, ASM ranged from 0.65 to 92.2%. The pooled prevalence of ASM globally was 43.0% (95% CI: 38.0, 48.1%). A high degree of heterogeneity across studies was shown with I2 = 99.2%, p < 0.001 assuming a random effect model. In subgroup analysis, the highest ASM pooled prevalence was 55.2% (95% CI: 47.2, 63.2) in sub-Saharan Africa followed by the Middle East, North Africa, and Greater Arabia at 48.3% (95% CI: 38.3, 58.4), Europe at 34.7% (95% CI:18.0, 56.4), and Asia at 25.8% (95% CI: 18.6, 34.6). Students have been identified as the major users of ASM at 62.1% (95% CI: 53.7, 69.7). The meta-regression showed a coefficient of 0.0365, -0.0117, and -0.0001 for a year of publication, recall time, and total sample size, respectively. Publication bias was demonstrated from the asymmetrical distribution of the funnel plot, and the Eggers regression p-value was greater than 0.05 (0.264). Moreover, knowledge of antibiotics (46.19% (95% CI: 27.99, 65.46)), previous successful experiences (39.13% (95% CI: 30.13, 48.93)), and perceiving illness as minor (38.10% (95% CI: 27.19, 50.37)) were the top three reasons pooled proportion for practicing ASM.

CONCLUSION

ASM practice was higher among African and student users. The previous successful experience was the most frequent reason reported. Educational level, gender, and age were often mentioned as predictor factors. Hence, designing interventional approaches that consider the different burdens among the target population and tackle the reasons for the practices might benefit averting antimicrobial resistance.

Self-Medication Practice and Associated Factors Among Health Professionals in Spain

(1) Background: Self-medication, defined as the use of medications without professional supervision, is a common practice that presents both potential benefits and significant risks. This study analyzes the prevalence, patterns, and determinants of self-medication among health professionals in Spain. (2) Methods: A cross-sectional descriptive design was employed with 438 health professionals, predominantly women (81.1%), with a median age of 42 years. The majority of the healthcare workers were nurses (45%). (3) Results: The results revealed a high prevalence of self-medication (59.4%). Analgesics and anti-inflammatory drugs were the most commonly used. Age and professional knowledge emerged as significant factors influencing this behavior. The main reasons for self-medication included the mildness of symptoms, easy access to medications, and previous successful experiences. Digital sources, especially websites, were the most consulted. Confidence in artificial intelligence tools as a clinical resource was moderate, with 18% of participants consulting AI tools, a rate comparable to the 19.5% for scientific databases. Logistic regression analysis identified age, knowledge of recommended doses, and perceived efficacy as significant predictors, while concern about risks acted as a protective factor. (4) Conclusions: This study highlights the need for educational interventions aimed at promoting responsible self-medication practices and mitigating associated risks among healthcare professionals.

Knowledge, Attitude, and Practice Towards Responsible Self-Medication Among Pharmacy Students: A Web-Based Cross-Sectional Survey in Uganda

Purpose

Rational self-medication (SM) practice among healthcare students is essential to promote the safe, effective, and economical use of medicines for self-diagnosed conditions. The study aimed to assess pharmacy students' knowledge, attitude, and practice about responsible self-medication.

Methodology

A cross-sectional online survey was conducted among Ugandan pharmacy students for one month from March 1 to March 31, 2024. The study included students enrolled in diploma, bachelor, and master of pharmacy programs in Uganda. Informed consent was obtained online by asking a question regarding willingness to participate. A non-probable snowball sampling technique was used to recruit students. A pre-validated questionnaire was used to obtain socio-demographics, self-medication practices, knowledge, attitudes, and practices about responsible self-medication. We used binary and multivariable logistic regression analysis to identify the factors associated with KAP regarding responsible self-medication.

Results

The prevalence of self-medication practice among pharmacy students was 96.73%. The self-medication is most common in headache (78.97%), cold, and cough (79.91%) illnesses. Painkillers (90.19%) and antibiotics (53.97%) are the most common medicines used for self-medication. Most pharmacy students have good knowledge (87.38%) and a positive attitude (96.03%) toward responsible self-medication. However, only 27.34% of students practice rational self-medication. Participants' university and parents' professions were significantly associated with good knowledge of responsible self-medication. Whereas factors such as gender, residence, and type of illness were significantly associated with rational self-medication practice.

Conclusion

The prevalence of self-medication was high among pharmacy students in Uganda. Painkillers and antibiotics are the most preferred drugs for self-medication. About 87.38% of pharmacy students have good knowledge, and 96.03% have a positive attitude toward responsible self-medication. Rational self-medication practice was low among students. We recommended training sessions to enhance safe self-medication practices among pharmacy students.

Prevalence and predictors of self-medication with antibiotics in Ethiopia: a systematic review and meta-analysis

INTRODUCTION

Antibiotic self-medication is a global public health concern contributing to antibiotic resistance. This systematic review and meta-analysis aim to assess the prevalence of antibiotic self-medication and its associated factors in Ethiopia.

METHODS

A comprehensive search of electronic databases was conducted from MEDLINE (PubMed), Scopus, Google Scholar and Web of Science to identify relevant studies published between 2000 and 2024. Adult households, undergraduate university students and health care professionals who had taken antibiotics without a prescription in the household setting were included in this review. The primary outcome of this review is antibiotic self- medication. The random-effects model was used to estimate pooled prevalence rates. The outcome measure was analyzed with STATA version 17 software.

RESULTS

A total of nine studies were included in the Meta-analysis, comprising a sample size of 5908 participants. The pooled prevalence of antibiotic self-medication among Ethiopians was found to be 46.14 with 95% Confidence Interval [35.71, 56.57]. The most frequently used classes of self-medicated antibiotics were penicillins, followed by tetracyclines. Community pharmacies were the source of information that individuals utilized. The most common reported reasons for antibiotic self-medication include previous experience of treating a similar illness, to save cost, lack of time and avoiding waiting time for medical services. Participants having less than high school educational level was the most commonly reported factor associated with self-medication antibiotics.

CONCLUSION

Antibiotic self-medication is a prevalent practice in Ethiopia. This underscores the need for targeted interventions such as educating people about the risks associated with using antibiotics without medical guidance, which results in a reduction in antibiotic resistance.

Prevalence and determinants of antibiotics self-medication among indigenous people of Bangladesh: a cross-sectional study

OBJECTIVES

Self-medication with antibiotics (SMA) contributes significantly to the emergence of antimicrobial resistance (AMR), especially in low-income countries including Bangladesh. This study aimed to generate evidence on the self-reported prevalence of antibiotic self-medication and its determinants among indigenous people residing in Bangladesh's Chittagong Hill Tracts (CHT) districts.

DESIGN

This study used a cross-sectional design with data collected through a survey using a semi-structured questionnaire.

SETTING

This study was conducted from late January to early July 2021; among different indigenous group populations aged 18 years or more olders residing in the three districts of CHT.

PARTICIPANTS

A total of 1336 indigenous people residing in Bangladesh's CHT districts were included.

PRIMARY OUTCOME AND EXPLANATORY VARIABLES

The primary outcome measure was SMA while explanatory variables were socio-demographic characteristics, health status of participants, and knowledge of antibiotics usage and its side effects.

RESULTS

Among the study participants, more males (60.54%) than females (51.57%) reported using antibiotics. The SMA rate was high among individuals with education levels below secondary (over 50%) and those in the low-income group (55.19%). The most common diseases reported were cough, cold and fever, with azithromycin being the most frequently used antibiotic. Levels of education, family income, having a chronic illness and place of residence were found to be the significant predictors of having good knowledge of antibiotic use as found in the ordered logit model. Findings from a logistic regression model revealed that men had 1.6 times higher odds (adjusted OR (AOR) 1.57; 95% CI 1.12 to 2.19) of SMA than women. Participants with ≥US$893 per month family income had lowest odds (AOR 0.14; 95% CI 0.03 to 0.64) of SMA than those who earned

CONCLUSION

Male gender, family income, place of residence and knowledge of antibiotics were the significant predictors of antibiotic self-medication. Hence, it is important to streamline awareness-raising campaigns at the community level to mitigate the practice of SMA in indigenous people and ultimately address the devastating effects of Antimicrobial resistance (AMR) in Bangladesh.

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Key Words

• EPIDEMIOLOGIC STUDIES
• EPIDEMIOLOGY
• PUBLIC HEALTH

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MESH Headings

• Humans
• Female
• Male
• Anti-Bacterial Agents/therapeutic use
• Cross-Sectional Studies
• Bangladesh
• Prevalence
• Indigenous Peoples

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Affiliation(s)

Adnan Mannan Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
Kallyan Chakma Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
Gourab Dewan Department of Medicine, Rangamati Medical College, Rangamati, Bangladesh
Ayan Saha Department of Bioinformatics & Biotechnology, Asian University for Women, Chattogram, Bangladesh
Naim Uddin Hasan A Chy Department of Economics, University of Chittagong, Chattogram, Bangladesh
H M Hamidullah Mehedi Department of Medicine, 250 Bedded General Hospital, Chattogram, Bangladesh
Amzad Hossain Department of Genetic Engineering & Biotechnology, Jagannath University, Dhaka, Bangladesh
Jannatun Wnaiza Department of Biochemistry & Biotechnology, University of Science and Technology Chittagong, Chattogram, Bangladesh
Md Tanveer Ahsan Department of Pharmacy, University of Chittagong, Chattogram, Bangladesh
Md Mashud Rana Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh Department of Pharmacology and Therapeutics, Chittagong Medical College, Chattogram, Bangladesh
Nazmul Alam Department of Public Health, Asian University for Women, Chattogram, Bangladesh

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Dermatology Self-Medication in Nursing Students and Professionals: A Multicentre Study

Current evidence shows that the prevalence of self-medication in healthcare professionals and their students is troublingly high despite them knowing the risks involved. There is limited research on self-medication in dermatology, and there are even fewer studies on this practice among nurses and nursing students, despite the potential mucocutaneous health problems that may affect them. The aims of our study were to examine the prevalence of self-medication mainly in the field of dermatology among nurses and nursing students as well as to explore if age or years of professional/academic practice influenced such behaviour. This multicentre cross-sectional study was conducted in 2021. In total, 120 nurses from the University Hospital of Pontevedra and 303 nursing students from the Universities of Vigo and Santiago de Compostela (N-W Spain) participated in this study (n = 423). An ad hoc questionnaire was used to evaluate self-medication decision-making. Self-medication for dermatological diseases was reported by 58.39% (n = 247) of participants. Among our respondents, 44.44% of nurses and 42.68% of students would recommend treatment for skin diseases to a third party. We found a higher prevalence of medication without prescription in nurses than in students (p < 0.001). More experience (p = 0.01) and older age (p < 0.001) were associated with more self-medication in the case of nurses and students, respectively. The prevalence of self-medication and treatment recommendation to a third party are cause for concern. Identifying these situations and associated factors may help to implement evidence-based strategies and education.

Self-medication and medication storage practices among Lira University students in Lira city, Northern Uganda

Background

Self-medication (SM) is a global public health concern, particularly prevalent in developing nations. It involves the consumption of drugs without professional guidance, encompassing both over-the-counter and prescription medicines. Responsible SM can alleviate healthcare burdens, reduce costs, and empower individuals to manage minor ailments independently. However, improper SM practices can lead to adverse effects, contribute to antimicrobial resistance, and pose various health risks. This study aimed to evaluate the prevalence of SM and related practices of storing medications among students at Lira University, located in Lira City West Division, Northern Uganda.

Methods

This study adopted a quantitative cross-sectional design, focusing on students from various faculties. The sample size comprised 422 students, determined using the Kish Leslie formula. Data collection involved the administration of self-administered questionnaires, and subsequent data analysis was performed using SPSS version 25.

Results

The study involved participants from Lira University, primarily women (51.2%) with an average age of 23.82. A majority were Christians (59.7%) and single (87.9%). Most were from the Faculty of Health Sciences (63.7%), with third-year students being the largest group (48.3%). Regarding SM, 74.2% practiced SM, with antibiotics (69.2%) and tablets (69.2%) being commonly self-administered. In terms of medication storage, 93.4% kept medicines at home, mostly in cupboards (76.5%), but many were unsure about proper storage practices. Participants exhibited good knowledge of SM's risks and measures to reduce them. There was a significant association between the faculty of study and SM practices (p = 0.015), while other demographic factors showed no significant associations.

Conclusion

This study sheds light on the prevalent SM practices among students at Lira University in Northern Uganda. Notably, antibiotics were frequently self-medicated, raising concerns about antibiotic resistance. Additionally, medication storage practices emphasize the need for proper education on storage guidelines. However, the participants exhibited good knowledge of the risks associated with SM, suggesting the potential for effective awareness campaigns. The study recommends targeted health education programs, stricter regulations on medication sales, improved healthcare access, proper medication disposal, further research on the factors driving SM, collaborative efforts, and monitoring of antibiotic use to address this public health issue effectively.

Relationship between the Health Literacy and Self-Medication Behavior of Primary Health Care Clientele in the Hail Region, Saudi Arabia: Implications for Public Health

BACKGROUND AND AIM

Because they are unaware of the potential adverse effects of medications, people frequently self-medicate as a form of self-care. This study aimed to investigate the factors associated with health literacy and the propensity to self-medicate among the primary healthcare clientele of the city of Hail, Saudi Arabia.

METHODS

This research employed a cross-sectional approach with the participation of 383 primary health center clientele of the Hail Region of Saudi Arabia. Participation was enacted via convenience sampling from December 2022 to February 2023. The data were collected using a self-administered questionnaire. The investigation utilized descriptive statistics as well as multiple linear regression and correlation for the data analysis.

RESULTS

Participants who were aged 30 years and above, single, had a college degree, were non-Saudi, had a white-collar occupation and received information from the internet/Google/YouTube had a significant relationship (p < 0.05) with health literacy. On the self-medication scale (SMS), there were significant relationships with age, marital status, educational level and occupation (p < 0.05). The nationality and source of information factors related to health had a positively significant effect on health literacy (p < 0.01), while middle age (24-29 years) had a positive effect on the self-medication scores (p < 0.01). There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS) scores (r = 421, p < 0.001).

CONCLUSION

Age of 30 years old or above, single status, a college degree, non-Saudi status, white-collar occupation and receiving information from the internet/Google/YouTube were all significant for health literacy. There were also significant relationships with the SMS scores for age, marital status, educational level and occupation. The factors affecting health literacy were older participant age, nationality and the source of information regarding health. Conversely, among the participants, being in the middle-aged group (24-29 years) was a factor that affected their self-medication scores. There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS).

The Utility of Internet-Enabled Antibiotic Self-Medication and Its Associated Factors Among Patients Attending Private Clinics in Kawempe Division in Kampala Capital City, Uganda: Community-Based Cross-Sectional Study

Introduction

The expanding practice of internet-based antibiotic self-medication raises public health concerns as it increases antibiotic resistance and introduces avoidable risks. This study aims to examine the utility of internet-enabled antibiotic self-medication and its associated factors among patients attending private clinics in Kawempe division in Kampala Capital City, Uganda.

Methods

This was an analytical cross-sectional study that enrolled participants attending private clinics in Kawempe Division's randomly selected zones. These were interviewed using a structured questionnaire, and the data were analyzed using STATA version 12 software. Logistic regression analysis was used, and variables with p ≤ 0.05 were considered as significantly associated with internet-enabled antibiotic self-medication.

Results

Out of the 313 respondents, 246 (79%) reportedly had ever used internet sources to self-medicate with antibiotics. Factors such as being male; single; had knowledge of antibiotics; believed that Internet should be used for antibiotic self-medication; Distance to the nearest medical center/hospital from your residence/workplace of about 5 km and residing near a drug shop/pharmacy that gives antibiotics without a prescription increased internet-enabled antibiotic self-medication. Furthermore, the variables of more than three household members; common practice of antibiotic self-medication in a household; did not agree that one can recover from the illness without a doctor's prescription and medical workers who did not explain adequately the antibiotics medication given for the illness decreased internet-enabled antibiotic self-medication.

Conclusion

This study found that internet-enabled antibiotic self-medication practice is highly utilized and is associated with a variety of individual, household, and healthcare system factors. This necessitates strict adherence to national drug policy regulations governing antibiotic use. Furthermore, community health education is critical in combating such medication practices.

Evaluating self-medication practices in Ethiopia

BACKGROUND

Self-medication with antibiotics has become an important factor driving antibiotic resistance and it masks the signs and symptoms of the underlying disease and hence complicates the problem, increasing drug resistance and delaying diagnosis. This study aimed to assess the extent of self-medication practice with antibiotics and its associated factors among adult patients attending outpatient departments (OPD) at selected public Hospitals, in Addis Ababa, Ethiopia.

METHODS

Facility-based cross-sectional study was employed. A systematic random sampling technique was used to include the study participants. Self-administered with structured questionnaires were applied among patients who visited outpatient departments at selected public Hospitals, in Addis Ababa. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26. Descriptive statistics such as frequencies and percentages were used for the present categorical data. The data are presented in pie charts, tables, and bar graphs. Furthermore, bivariable and multivariable binary logistic regression analyses were used to identify significant associations. Statistical significance was declared at p value < 0.05.

RESULTS

Out of 421 respondents interviewed, 403 (95.7%) participants completed questionnaires. Among the respondents, 71% had generally practiced self-medication. Among these, 48.3% had self-medication with antibiotics, while 51.7% had used other drugs. The most commonly cited indication for self-medication practice was abdominal pain 44.9%, followed by Sore throat 21% commonly used antibiotics are amoxicillin (57%), ciprofloxacin (13%), amoxicillin/clavulanic (10%), erythromycin (8%), cotrimoxazole (7%), and doxycycline (5%).

CONCLUSIONS

Self-medication with antibiotics was common among the study participants. The prevalence of general self-medication was 71%, whereas that of self-medication with antibiotics was 48.3%. In general, the potentially dangerous effects of SMP seem to be underestimated by patients with OPD patients.