Prevalence, associated factors and reasons for antibiotic self-medication among dwellers in Anuradhapura: a community-based study

Background Antimicrobial resistance is cited as one of the leading causes for the increased morbidity and mortality in infectious diseases globally. Antibiotic misuse can accelerate the advent and spread of resistant antimicrobial strains and antibiotic self-medication is one of the main practices of antibiotic misuse. Even though plethora of evidence is available on antibiotic self-medication among health care providers, evidence derived from community-based studies are scarce. Objective We aimed to determine the prevalence, associated factors and reasons for antibiotic self-medication among dwellers of Anuradhapura, Sri Lanka. Setting The study was conducted in Nuwaragam Palatha East, Medical Officer of Health area, Anuradhapura, Sri Lanka. Method A community-based, cross-sectional study was conducted to collect data on antibiotic self-medication during the last 3 months from all selected households using a self-administered questionnaire. Binary logistic regression was performed to determine the significant associations between variables of interest and the practice of antibiotic self-medication. Main outcome measure The prevalence of antibiotic self-medication was computed as a point estimate with 95% Confidence Interval. The reasons for antibiotic self-medication were presented as frequency and percentages. Results Of the 384 participants selected from 125 households, 211 (55%) had consumed antibiotics during the last three months and only ten were found to have self-medicated antibiotics. Hence, the prevalence was 2.6% (95% Confidence Interval = 1.0 to 4.2). The practice of antibiotic self-medication was not significantly associated with age, household size, sex, family income, employment or education level (P > 0.05). The most common symptom and reason to take antibiotics without a prescription was runny nose (80%-8/10) and convenience (70%-7/10) respectively. All have purchased the antibiotic for self-medication from a pharmacy. Information on the use of the antibiotic and the dosage were obtained from a physician's previous prescription (60%-6/10) or a pharmacist (40%-4/10). Conclusion The study revealed a very low prevalence of antibiotic self-medication. However, continuous surveillance of retail pharmacies and training of health care providers is needed to curtail errors in the use of antibiotics.