Self-Medication with Antibiotics among University Students in LMIC: A systematic review and meta-analysis

Abstract

INTRODUCTION: Self-medication with antibiotics (SMA) is common among university students in low and middle-income countries (LMICs). However, there has been no meta-analysis and systematic review in the population. METHODOLOGY: A literature search was conducted using PubMed, Embase and Web of Science for the period from January 2000 to July 2018. Only observational studies that had SMA among university students from LMICs were included. A random-effects model was applied to calculate the pooled effect size with 95% confidence interval (CI) due to the expected heterogeneity (I2 over 50%). RESULTS: The pooled prevalence of SMA of overall included studies was 46.0% (95% CI: 40.3% to 51.8%). Africa had the highest pooled prevalence of SMA among university students (55.30%), whereas South America had the lowest prevalence (38.3%). Among individual LMICs, the prevalence of SMA among university students varied from as low as 11.1% in Brazil to 90.7% in Congo. CONCLUSIONS: The practice of SMA is a widespread phenomenon among university students in LMICs and is frequently associated with inappropriate use. Effective interventions such as medication education and stricter governmental regulation concerning antibiotic use and sale are required to be established in order to deal with SMA properly.