Abstract
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. 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%). 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. 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.
Highlights
Self-medication with antibiotics (SMA) is common among university students in low and middle-income countries (LMICs)
The inclusion criteria were as follows: 1) study focused on the relationship between SMA and university students; 2) participants were university students; 3) the prevalence of SMA in university students and total sample size reported; 4) study analyzed all types of antibiotics; 5) only papers written in English were included, 6) Studies were done in LMICs
The top three countries with the highest prevalence are in Africa (Congo, Sudan and Ghana). These findings reveal that some countries in Africa were poorly controlled for antibiotics use among university students
Summary
Self-medication with antibiotics (SMA) is common among university students in low and middle-income countries (LMICs). 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. A review reported that current deaths attributable to antimicrobial resistance every year is 700000 (low estimate) This number is expected to rise to 10 million by 2050, if no effective preventive measures are adopted to reduce people’s use of antibiotics [9]. In low and middle-income countries (LMICs) this issue is increasingly exacerbated due to the rapid economic and population growth [10]
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