Abstract
BackgroundSelf-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance. The purpose of this study was to evaluate the prevalence of self-medication with antibiotics for the treatment of menstrual symptoms among university women in Southwest Nigeria.MethodsA cross-sectional survey was administered to female undergraduate and graduate students (n = 706) at four universities in Southwest Nigeria in 2008. The universities were selected by convenience and the study samples within each university were randomly selected cluster samples. The survey was self-administered and included questions pertaining to menstrual symptoms, analgesic and antibiotic use patterns, and demographics. Data were analyzed using descriptive statistics and logistic regression.ResultsThe response rate was 95.4%. Eighty-six percent (95% CI: 83-88%) of participants experienced menstrual symptoms, and 39% (95% CI: 36-43%) reported using analgesics to treat them. Overall, 24% (95% CI: 21-27%) of participants reported self-medicated use of antibiotics to treat the following menstrual symptoms: cramps, bloating, heavy bleeding, headaches, pimples/acne, moodiness, tender breasts, backache, joint and muscle pain. Factors associated with this usage were: lower levels of education (Odds Ratio (OR): 2.8, 95% CI: 1.1-7.1, p-value: 0.03); non-science major (OR: 1.58, 95% CI: 1.03-2.50, p-value: 0.04); usage of analgesics (OR: 3.17, 95% CI: 2.07-4.86, p-value: <0.001); and mild to extreme heavy bleeding (OR: 1.64, 95% CI: 1.01-2.67, p-value: 0.05) and pimples/acne (OR: 1.57, 95% CI: 0.98-2.54, p-value: 0.06). Ampicillin, tetracycline, ciprofloxacin and metronidazole were used to treat the most symptoms. Doctors or nurses (6%, 95% CI: 4-7%), friends (6%, 95% CI: 4-7%) and family members (7%, 95% CI: 5-8%) were most likely to recommend the use of antibiotics for menstrual symptoms, while these drugs were most often obtained from local chemists or pharmacists (10.2%, 95% CI: 8-12%).ConclusionsThis is the first formal study to report that approximately 1 out of 4 university women surveyed in Southwest Nigeria self-medicate with antibiotics to treat menstrual symptoms. This practice could provide monthly, low-dose exposures to antibiotics among users. Further studies are necessary to evaluate the impacts of self-medication on student health.
Highlights
Self-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance
The private universities were Covenant University (6,000 total students) and Babcock University (6,000 total students), which are both located in Ogun State. These universities were selected via convenience sampling and were included in the study because students attending public versus private universities often represent different socioeconomic groups and we sought to evaluate whether socioeconomic status is one potential factor that influences the use of antibiotics for menstrual symptoms among university women
In this study, we identified that approximately 1 out of 4 surveyed female university students in Southwest Nigeria practiced self-medication with antibiotics to treat a variety of menstrual symptoms
Summary
Self-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance. Because the misuse and abuse of antibiotics is a major cause of antimicrobial resistance, research is needed to evaluate the specific antibiotic usage patterns that are prevalent in developing countries so that interventions can be developed and implemented For such interventions to be effective, we must understand the underlying socio-cultural factors that contribute to antimicrobial misuse and the subsequent amplification of resistance in human populations [1,2]. Counterfeit drugs and poor pharmaceutical qualities of available antimicrobials (containing no or substandard active ingredients) have been widely reported [7,8,9] These factors often lead to higher rates of resistance to lessexpensive first-line regimens compelling subsequent changes in treatment protocols to include more expensive and sometimes more toxic drugs [10]. Patronage of “quacks,” untrained individuals providing unconventional and unhygienic medical care, is widespread and frequently becomes institutionalized as normal
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