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Published on: August 30, 2018
Is self-medication with antibiotics among the public a global concern: a mixed-methods systematic review
Tenghao Wang1, Jianxiong Wu1,2, Jinxi Li1
1Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Background:
Irrational use of antibiotics is a major driver of antimicrobial resistance. Self-medication with antibiotics (SMA) may exacerbate antimicrobial resistance in the community without professional diagnosis by physicians, due to the complexity of the pharmacological mechanisms. There is still a lack of assessment of the global prevalence of SMA. We have evaluated the global prevalence of SMA and its associated factors, which could provide more reliable data to support global action.
Methods:
We searched PubMed, Embase, Web of Science, and EBSCO CINAHL Plus. Quantitative studies were combined using meta-analysis with random-effects models, and qualitative synthesis was performed using interpretive meta-ethnographic methods.
Results:
A total of 242 studies were included in this study. The pooled prevalence of SMA was 27.7% (95%CI: 24.9%-30.5%). Quantitative studies indicate that high income level, having family members working in the healthcare system, storing antibiotics at home, and purchasing antibiotics without prescriptions were associated with a greater likelihood of SMA. Qualitative findings revealed the following four factors: individual characteristics, healthcare, pharmacy, and social networks.
Conclusions:
The prevalence of global SMA among the public remains high level. Multisectoral and community-based interventions are needed to reduce SMA, including targeted health education, improved access to healthcare, and regulation of antibiotics sales in pharmacies.
Registration:
PROSPERO (CRD42023402206).
Insights
Self-medication with antibiotics (SMA) affects over a quarter of the global population, contributing to antimicrobial resistance. Interventions targeting health education and pharmacy regulations are crucial to curb this practice.
Area of Science:
- Public Health
- Infectious Diseases
- Pharmacology
Background:
- Irrational antibiotic use is a primary driver of antimicrobial resistance.
- Self-medication with antibiotics (SMA) poses a significant threat to community antimicrobial resistance without professional medical oversight.
- Global prevalence data for SMA is currently insufficient.
Approach:
- A comprehensive literature search was conducted across PubMed, Embase, Web of Science, and EBSCO CINAHL Plus.
- Quantitative data from eligible studies were synthesized using meta-analysis with random-effects models.
- Qualitative findings were explored through interpretive meta-ethnographic methods.
Key Points:
- The pooled global prevalence of SMA was found to be 27.7% (95% CI: 24.9%-30.5%).
- Factors associated with increased SMA include higher income, family in healthcare, home antibiotic storage, and purchasing without prescriptions.
- Qualitative analysis identified individual characteristics, healthcare access, pharmacy practices, and social networks as key influencing factors.
Conclusions:
- The global prevalence of SMA remains alarmingly high.
- Multisectoral and community-based interventions are essential to mitigate SMA.
- Recommended interventions include targeted health education, enhanced healthcare accessibility, and stricter regulation of antibiotic sales in pharmacies.
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