Prevalence and predictors of self-medication with antibiotics in selected urban and rural districts of the Dodoma region, Central Tanzania: a cross-sectional study

BACKGROUND: Antibiotic resistance is a global health threat driven partly by self-medication with antibiotics (SMA). This study aims to assess the prevalence and predictors of SMA in selected rural and urban communities of the Dodoma region, Central Tanzania. METHODS: This cross-sectional study was conducted in Chemba District Council (rural) and Dodoma City Council (urban) from August to November 2019 using multistage stratified random sampling. Data were collected through face-to-face interviews using structured questionnaires. RESULTS: A total of 430 respondents were interviewed in Chemba District Council (rural) (161/430) and Dodoma City Council (urban) (269/430). The prevalence of SMA was 23.6% (38/161) among rural respondents and 23.4% (63/269) among urban respondents. The median amount of SMA in both settings was 2, while the maximum amounts were 4 and 5, respectively. SMA among rural and urban participants was associated mostly with perceived cough (76.3%/82%), body pain (71.1%/41.5%) and fever (63.2%/39.7%), and amoxicillin was the most commonly used antibiotic in both settings (47.3%/41%). Rural participants who reported a shorter perceived distance to a health care facility than to a drug outlet were 58.9% less likely to practise SMA (adjusted OR: 0.421; 95% CI: 0.388, 0.458; p < 0.001), whereas SMA decreased by 16.3% among urban participants who reported a shorter perceived distance to a health care facility than to a drug outlet (adjusted OR: 0.837; 95% CI: 0.755, 0.929; p < 0.001). SMA was 17.3% lower among farmers than among nonfarmers in the urban area (adjusted OR: 0.827; 95% CI: 0.716, 0.955; p = 0.01), while farming had no effect in the rural area. CONCLUSIONS: The prevalence of SMA is similar among participants in rural and urban districts. In both localities, a shorter perceived distance to a drug outlet is an independent risk factor for SMA, while having health insurance reduces the risk. Equally weighted interventions to reduce SMA are required in rural and urban communities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13756-022-01124-9.