Abstract
BackgroundSelf-medication with antibiotics (SMA) has been reported among university students in many countries, but little research has been done on this issue in China. The objective of this study was to evaluate knowledge and behaviors of university students and risk factors concerning SMA.Methodology/Principal FindingsUsing a novel questionnaire-based data collection instrument, an anonymous online survey was conducted with the students of Shantou University (STU), a university comprising 8 schools/colleges in eastern Guangdong, China. Of 1,300 respondents (13.8% of total eligible participants), 47.8% had self-treated with antibiotics. Logistic regression analysis identified prior knowledge of antibiotics (PKA), older age, and higher monthly allowance as independent risk factors for SMA. PKA significantly influenced students' knowledge about antibiotics, their uses, and common adverse reactions (all p<0.05). Among self-medicated students, 61.7% used antibiotics at least twice in the previous year. Community pharmacies were the major source of self-prescribed antibiotics. Reported common indications for SMA were sore throat (59.7%), fever (38.2%), cough (37.4%), runny nose (29.3%), and nasal congestion (28.7%). While 74.1% of self-medication episodes were based on students' own experiences, only 31.1% of students claimed to understand the package insert. Alteration of antibiotics and dosage during the course of self-treatment was made by 63.8% and 55.6% of students, respectively. At least two kinds of antibiotics were simultaneously taken by 82.6% of students. The majority of self-medicated students failed to complete the course of antibiotics. Adverse reactions were reported by 16.3% of students. Amoxicillin was the most common antibiotic used for self-medication.ConclusionsHigh prevalence of SMA was noted among STU students. Presence of risk factors and risk-associated behaviors/attitudes in the study population calls for focused educational intervention and stricter governmental legislation and regulation of antibiotic use and sale in pharmacies.
Highlights
Irrational use or abuse of antibiotics is a global public health problem [1]
High prevalence of Self-medication with antibiotics (SMA) was noted among Shantou University (STU) students
Presence of risk factors and risk-associated behaviors/attitudes in the study population calls for focused educational intervention and stricter governmental legislation and regulation of antibiotic use and sale in pharmacies
Summary
Antibiotic abuse leads to wastage of medical resources, and contributes to the emergence of multi-drug resistant pathogens [2,3]. While some developed countries have strict regulations on antibiotic use [4], developing countries are breeding grounds for drug-resistant bacteria due to poor supervision of antibiotic prescription [2,5]. Self-medication with antibiotics (SMA) is one form of antibiotic abuse, which is prevalent in developing countries with loose regulatory systems [7,8]. Lower SMA prevalence has been reported in developed countries with 3% in northern Europe, 6% in central Europe, and 19% in southern Europe [1]. Self-medication with antibiotics (SMA) has been reported among university students in many countries, but little research has been done on this issue in China.
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