Antibiotic self-medication and knowledge about antimicrobial resistance among medical and non-medical students of the University of Dodoma, Tanzania

Abstract

Background: Antibiotic misuse and overuse are the major driving factors of antimicrobial resistance (AMR). High-income countries have been conscious of the problem for several years, while Tanzania shows the increasing trend of self-medication with antibacterial drugs. This study aimed to compare the antibiotics use practice and awareness about AMR among undergraduate students of the largest Tanzanian university. Methods and materials: Self-administered questionnaires were distributed among 2nd year medical (MDS) and non-medical students (non-MDS) at the University of Dodoma, Tanzania. A total of 356 respondent's answers were analyzed in the study. Statistical analysis was done by using MedCalc statistical software. p < 0.05 was considered statistically significant. Results: Non-MDS were more prone to use self-medication with antibiotics compared to MDS group: 46.2% and 35.1%, respectively (OR 1.58, 95%CI: 1.0 to 2.5). Among them, 45.5% of non-MDS and 49.2% of MDS reported an inability to visit a doctor as the main reason for the self-treatment. Moreover, non-MDS replied that they did not attend the doctor for financial reasons (OR 4.64, 95%CI: 2.05 to 10.46). Most students relied on a previous experience to choose medicine type: 76.3% MDS and 57.6% non-MDS (OR 2.36, 95%CI: 1.09 to 5.13). The next most common approach, notably popular among Tanzanian students, was to follow Pharmacist's recommendations: 22% MDS and 24.2% non-MDS. All surveyed participants demonstrated a high level of awareness regarding the antibiotic indications. However, less than half of MDS (46.2%) knew about AMR, and only 19.1% of non-MDS were familiar with the problem (OR 3.63, 95%CI 2.22 to 5.95). Furthermore, 48.8% of MD and 27.3% of non-MD students did not finish an entire course of antibiotics (OR 2.54, 95%CI 1.58 to 4.09) and stopped taking a drug mainly when the symptoms of disease disappeared. Analysis of antibiotic trends showed Ampicillin, Amoxicillin and others from Penicillin group to be the most popular among Tanzanian undergraduates. However, many students confused antibiotics, pain killers and antiallergic medicines. Conclusion: Our findings indicated the high rate of self-medication with antibiotics and AMR illiteracy among undergraduate students that proved the necessity of educational programs, antibiotic use guidance and the control of sales of antibiotics in the country.