Practices and Factors for Self-Medication with Antibiotics Among Patients and Medical Students in Tunisia: A Cross-Sectional Study

Abstract

Self-medication with antibiotics (SMA) becomes generally common practice due to multiple factors. This study aimed to identify the prevalence and factors associated with SMA among patients and medical students in Tunisia. A cross-sectional study was conducted between March 2018 and October 2018 on 752 subjects. The sample of this study consisted of 153 patients in the outpatient clinic of two Universities Hospitals (Habib Bourguiba and Hedi Chaker in Sfax, Tunisia) and 559 students in the Medical universities of Tunisia. The inclusion criteria included adult patients (≥18 years) who see in one of both hospitals during the study and Medical students who accepted to access the questionnaire on Google forms. Data were collected through a structured questionnaire reliable and validated by a pilot test in a subsample of participants. Data were analyzed using SPSS. Student’s t-test and Mann-Whitney U test were used to compare differences between quantitative variables. Pearson's chi-square test was carried out to evaluate associations between qualitative variables. Of 752 participants, 71.68% self-medicated (70.9% of patients and 72% of medical students). There were no significant differences in SMA between patients and medical students (<I>P</I>=0.738). Amoxicillin was the most commonly used antibiotic for SM by patients (67.6%) and medical students (74.5%) (<I>P</I>=0.149). Furthermore, the most common indications for the use of self-medicated antibiotics were angina, influenza-like illness, and fever were the most frequent indications for the use of self-medicated antibiotics by patients (56.5%, 60.2%, 28.7%) and medical students (60.1%, 40.8%, 17.9%) (<I>P</I>=0.494, <I>P</I>=0.001, <I>P</I>=0.012). Furthermore, for reasons following previous experience, time-saving, and easy availability of drugs from pharmacies, the difference was statistically different between the two groups, with an increase in medical students compared to patients. The major source of information was pharmacies. Ninety-seven patients (90%) and 364 students (88.8%) got their antibiotics based on pharmacist consultancy. SMA is a common practice among patients and medical students in Tunisia. This infers the need for interventions to prevent the SMA, such as the implementation of appropriate health organizations for public education concerning the risks and consequences for the health of SMA.