Use and self-medication with antibiotics among adults in the Brazilian Amazon: a panel of two cross-sectional studies, 2015 and 2019

Abstract

ABSTRACT Background The aim of this study was to investigate the prevalence of antibiotics use and self-medication among adults living in Manaus, Amazonas in 2015 and 2019. Research design and methods Analysis of two cross-sectional studies conducted in Manaus in 2015 and 2019. Adults aged ≥18 years were interviewed at home following a three-phase probabilistic sampling (census tracts, household, and individual). Primary outcome was the use of antibiotics in the previous 15 days. Poisson regression with robust variance was employed to calculate the prevalence ratios (PR) of antibiotics use adjusted by independent variables. Results The prevalence of antibiotics use in the previous fortnight was 3.7% (95%CI 3.1–4.4%; n=3,479) in 2015 and 8.0% (95%CI 6.7–9.3%; n=2,321) in 2019. Self-medication increased from 19.2% (95%CI 12.4–26.0%; n=130) in 2015 to 30.7% (95%CI 22.5–38.8%; n=187) in 2019. Beta-lactams were the most used (252/317) and self-medicated (60/317) antibiotics in both surveys. Use of antibiotics was higher in 2019 (PR=2.05; 95%CI 1.60–2.64) compared to 2015 and among women (PR=1.66; 95%CI 1.16–2.39) compared to men. Conclusions Antibiotics use and self-medication in Manaus increased from 2015 to 2019. Enforcement of health regulation is needed to improve compliance and minimize potential risks.