Jabeen Roshan, Shaikh Aqsa, Gautam Richa, Nabi Nusrat, Sultana Eram, Bano Aysha
Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, IND.
Pharmacology, Hamdard Institute of Medical Sciences and Research, New Delhi, IND.
Cureus. 2025 May 22;17(5):e84623. doi: 10.7759/cureus.84623. eCollection 2025 May.
Objectives The misuse of antibiotics fuels antimicrobial resistance (AMR), rendering treatments ineffective, increasing healthcare costs, and increasing mortality. This study estimated the prevalence, patterns, and drivers of self-medication with antibiotics (SMA) among adults, alongside exploring the reasons behind this practice. Methodology This community-based mixed-method study ran from January 2023 to June 2024. Simple random sampling selected 250 participants for the quantitative component, and purposive sampling chose 19 participants for the qualitative component. Descriptive statistics, cross-tabulation, and logistic regression were executed using SPSS (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp). Thematic analysis of focus group discussions (FGDs) was done using NVivo 14 (Lumivero 2023, Version 14, Denver). Results The prevalence of SMA was 36.4%(95% confidence interval (CI): 31.4-41.4), with 63 (69.2%) participants self-medicating at least once in the past three months, primarily for cold and flu-like symptoms (29, 31.86%) and fever (27, 29.69%). Key predictors of SMA were marital status, religion, education level, socioeconomic class, presence of chronic disease, knowledge, and attitude. Four (4.4%) participants experienced adverse drug reactions, 167 (66.8%) had inadequate knowledge about antibiotics, with only 13 (5.2%) aware of AMR, 142 (56.8%) had a favorable attitude towards SMA, and 171 (68.4%) followed appropriate practices. FGDs identified convenience, trust in local chemists, economic constraints, misinformation, long waiting times, limited healthcare access, and community acceptance as SMA drivers. Conclusion The study found that the prevalence of SMA in South-East Delhi surpasses rates in other regions of the country and signals a critical public health concern. To address SMA and mitigate AMR, authorities should enforce stricter regulations on over-the-counter antibiotic sales and implement targeted community education programs to enhance awareness of rational antibiotic use and AMR risks. These interventions, by improving regulatory oversight and knowledge, can effectively reduce SMA and safeguard antibiotic efficacy.
目标 抗生素的滥用助长了抗菌药物耐药性（AMR），使治疗无效，增加了医疗成本，并提高了死亡率。本研究估计了成年人自我用药使用抗生素（SMA）的患病率、模式和驱动因素，同时探究了这种行为背后的原因。方法 这项基于社区的混合方法研究于2023年1月至2024年6月进行。简单随机抽样选取了250名参与者进行定量部分的研究，目的抽样选取了19名参与者进行定性部分的研究。使用SPSS（IBM公司。2019年发布。适用于Windows的IBM SPSS Statistics，版本26.0。纽约州阿蒙克：IBM公司）进行描述性统计、交叉制表和逻辑回归分析。使用NVivo 14（Lumivero 2023，版本14，丹佛）对焦点小组讨论（FGD）进行主题分析。结果 SMA的患病率为36.4%（95%置信区间（CI）：31.4 - 41.4），在过去三个月中，有63名（69.2%）参与者至少自我用药一次，主要用于治疗感冒和流感样症状（29例，31.86%）以及发烧（27例，29.69%）。SMA的关键预测因素包括婚姻状况、宗教信仰、教育水平、社会经济阶层、慢性病的存在、知识和态度。4名（4.4%）参与者经历了药物不良反应，167名（66.8%）对抗生素知识了解不足，只有13名（5.2%）知晓AMR，142名（56.8%）对SMA持积极态度，171名（68.4%）遵循了适当的做法。焦点小组讨论确定便利性、对当地药剂师的信任、经济限制、错误信息、等待时间长、医疗服务获取有限以及社区接受度是SMA的驱动因素。结论 该研究发现，德里东南部SMA的患病率超过该国其他地区，这标志着一个严重的公共卫生问题。为了解决SMA并减轻AMR，当局应加强对非处方抗生素销售的监管，并实施有针对性的社区教育项目，以提高对合理使用抗生素和AMR风险的认识。通过改善监管监督和知识水平，这些干预措施可以有效减少SMA并保障抗生素的疗效。
