Abstract
Purpose: To investigate the prevalence of antibiotic use without prescriptions and to identify factors associated with this behavior among university students using oral non-prescription drugs (ONPD).
 Methods: A cross-sectional study was conducted among the students of major universities in UAE. A multistage sampling technique was used in the present study.
 Results: Out of 2875 students, only 2355 (81.9 %) questionnaire were fully answered and included. Of 2355, more than half (1348; 57.2 %) of the participants reported using ONPD. More than one-third (484, 35.9 %) of 1348 participants used antibiotics without a prescription during the 90 days prior to the present study. Binary logistic regression identified nine statistically significant variables: nationality (OR = 0.471, 95 % CI: 0.326 - 0.681, p < 0.001); cost-influence behavior (OR = 1.716, 95 % CI: 1.175 - 2.508, p < 0.005); belief in ONPD effectiveness (OR = 0.332, 95 % CI: 0 .135 - 0.815, p < 0.05); year of study (OR = 0.310, 95 %, CI: 0.141 - 0.681, p < 0.004); medication knowledge (OR = 0.619, 95 % CI: 0.443 - 0.866, p < 0.005); self-care orientation (OR=1.878, 95 % CI: 1.304 - 2.706, p < 0.001); using ONPD helps to save money (OR=1.665, 95 % CI: 1.047-2.649, p<0.04); and urgency of use (OR = 1.644, 95 %, CI: 1.144 - 2.363, p < 0.007); as well as being healthcare students (OR = 1.465, 95 %, CI: 1.012 - 2.120, p < 0.05).
 Conclusion: There is a need for educational intervention to improve students’ knowledge, attitude, and awareness regarding the risk of using antibiotics without prescriptions.
Highlights
Bacteria have specific genetic characteristics, which enable the microorganisms to develop resistance to antibiotics
The aim of this study is to measure the present prevalence of using antibiotic without prescription and identify the risk factors associated with this behaviour among university students in UAE
Another possible reason is a false sense of confidence in self-diagnosis and self-treatment among participants who use antibiotics without prescription and this speculation is consistent with that of Pan et al [18] who concluded that a false sense of confidence in self-treatment and easy access to antibiotics without prescription had encouraged Chinese students to selfmedicate with antibiotics without medical consultation
Summary
Bacteria have specific genetic characteristics, which enable the microorganisms to develop resistance to antibiotics. Purchase of antibiotics without a prescription is estimated to account for 50 % worldwide [4] This implies that users are selfmedicating and are likely to misuse these products. Such irresponsible use of nonprescribed antibiotics is a major global public health problem [5]. Self-medication has been identified as a key cause for increased antimicrobial resistance [2] and this trend constitutes a global public health concern. This again is of particular interest in developing countries [3,6] as it contributes to the spread of antimicrobial resistance, cross-resistance and treatment failure on a global level [7].
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