Prevalence and pattern of self-medication with antibiotics among residents of Abia State, Southeastern Nigeria: a call for action

Abstract

Background: Antibiotic self-medication occurs worldwide, and it is a major driver of antibiotic misuse and antimicrobial resistance. In developing countries like Nigeria, antibiotics are frequently sold as over-the-counter medications. There is a need to explore this pattern, aiding stakeholders in informed decision-making. We assessed the prevalence and pattern of antibiotic self-medication among the residents of Abia State. Methods: A cross-sectional study was conducted among eligible adults in the State with respondents selected using the multistage sampling technique. An interviewer-administered questionnaire was used to obtain information from the respondents. Data analysis was done using SPSS version 26 and the level of significance was set at 5%. Results: A total of 1,491 respondents were surveyed. The mean age was 34.7±13.1 years and females constituted 55.7%. The overall prevalence of antibiotic self-medication was 46.5% (95%CI: 43.9-49.1). The majority of the respondents took self-medication for cough (48.6%) and ampicillin/cloxacillin was the major antibiotic used (30.1%). The reason for antibiotic self-medication mostly reported was the perception of minor illness (62.7%). Most (52.4%) of the respondents got the antibiotics from pharmacies without prescriptions. The predictors of antibiotic self-medication included residence (aOR=2.44, 95% CI: 1.12-5.30), retention of previous prescriptions (aOR=10.98, 95% CI: 4.40-27.47), storage of leftover antibiotics (aOR=4.13, 95% CI: 1.79-9.54) and perceived susceptibility of antibiotic self-medication (aOR=4.96, 95% CI: 1.71-14.39). Conclusions: Close to half of the residents practiced antibiotic self-medication with its pattern identified. We recommend tailored strategies including appropriate health education and enforcement of regulatory policies to promote community antibiotic stewardship.