Perception and practice of self-medication with antibiotics among medical students in Sudanese universities: A cross-sectional study

Abstract

Introduction The benefits of antibiotics are under threat by self-medication, which culminated in economic burdening of developing countries, treatment failures, the emergence of antibiotic-resistant strains of bacteria and an increased probability of exposure and infection of the general population by antibiotic-resistant bacterial strains. Objectives This study aimed to evaluate the knowledge and attitude of medical students in Sudan towards the use of antibiotics, the prevalence of self-medication with antibiotics among medical students in Sudan and to identify risk factors which promote self-medication with antibiotics. Materials and methods This was a cross-sectional, descriptive and institution-based study, between November 2020 and May 2021. 1,110 medical students were selected by multistage cluster sampling. Logistic regression was used to identify risk factors of self-medication with antibiotics among the study participants. Results The median knowledge score was 7 out of a maximum of 10 (IQR: 5–8). A moderately positive attitude was observed among the participants (Median: 7/10; IQR: 6–8). Knowledge and attitude scores were significantly associated with academic year and monthly allowance (p < 0.05). 675 (60.8%) self-medicated with antibiotics within the previous 12 months, mostly from community pharmacies (321/675; 47.5%). Antibiotics were most commonly used to treat respiratory tract infections (38.1%) and cough (30.4%). Chi-square analysis demonstrated that self-medication with antibiotics was significantly associated with gender, year of study and monthly income. Conclusions Undergraduate medical students had moderate knowledge and attitude towards antibiotic use and antibiotic resistance, and an alarmingly high prevalence of self-medication with antibiotics. This highlights the urgent need for tighter legislation regarding the sales of antibiotics in community pharmacies by the state and federal health ministries.

Self-Medication as an Important Risk Factor for Antibiotic Resistance: A Multi-Institutional Survey among Students

“…One of the most common wrong practices in Pakistan is self-medication or the misuse of antibiotics in which the people usually take the medication without any consultation from physicians or clinicians [ 15 , 17 , 20 ]. Mindful of the worst AMR situation in Pakistan, the current study was conducted with the concept of self-medication among youth, asking why students choose self-medication, why a number of students were taking antibiotics, where did they gain knowledge about self-medication or to treat the illness/disease, and how did they combat seasonal and routine health issues.…”

“…The current study also noted that it was very rare that students were only using traditional medicines against coughing, flu, and diarrhea, and chest pain, while the most frequent medicinal categories were antimicrobial agents, anti-inflammatory, multivitamins, and for gynae purpose. A study from Sudan also highlighted that the self-medication was mainly performed in case of respiratory tract infections (38.1%) and cough (30.4%) [ 15 ].…”

“…The main problems related to self-medication are increased resistance to pathogens, causing serious health hazards such as prolonged suffering and adverse reactions. Nowadays, antimicrobial resistance is a worldwide problem that may be caused by antibiotics given without prescription [ 15 , 16 , 17 ].…”

Knowledge, Attitude and Practice of Pharmacy Professionals Against Dispensing Antibiotics Without Prescription in Ethiopia

“…5,10,11 Community pharmacies and drug stores are the main sources of antimicrobials, healthcare professionals especially pharmacy professionals, play a major role in DAWP impacted by myriad factors. 3,6,[12][13][14] Accessibility of community pharmacies, customer pressure, time and financial cost, weak regulatory enforcement mechanisms, and patients' trust in pharmacy professionals are the commonly quoted determinants of DAWP. 3,6,13,[15][16][17][18] Self-medication and DAWP in drug retail outlets is inappropriate practice that can accelerate the emergence and spread of antibiotic resistance.…”

Survey of the Knowledge, Attitudes and Practice towards Antibiotic Use among Prospective Antibiotic Prescribers in Serbia

“…In addition, studies conducted in Nepal, India, Sri Lanka and China all showed that the common cold was the most common medical condition for which medical students self-medicated with antibiotics [ 18 , 48 , 49 ]. Slightly different results were observed in the Sudanese study, where the most common symptoms treated by medical students with non-prescription antibiotics were acute respiratory tract symptoms, cough and common cold [ 50 ]. Furthermore, the findings from the UK study showed that 25% of dentistry students were of the opinion that antibiotics were effective against colds [ 51 ].…”