Trends in Practices of Self-Medication with Antibiotics among Medical Undergraduates in India

BACKGROUND: Self-medication with antibiotics (SMA) without the consultation of a professional is a serious health concern and can lead to serious health hazard. This study was designed to evaluate the trends in SMA behavior and risk factors in medical undergraduates to further explore the association between SMA practices and adverse drug events (ADEs). MATERIALS AND METHODS: This cross-sectional questionnaire-based study was carried out among 360 volunteering medical undergraduates at a tertiary care teaching hospital in New Delhi. RESULTS: 67.78% of students (244/360) gave a history of SMA practice with females dominating (54.09%). Out of 244 students giving a positive history of SMA, 182 (74.59%) experienced ADE, reflecting a strong positive association between the two. Convenience (86.07%) was observed to be the main reason of practicing SMA in this study. Over-the-counter sale of prescription-only drugs, namely antibiotics by the community pharmacies, is as high as 90.16%, leading to the main source of acquiring antibiotics for self-medication. Fever (47.54%) and respiratory infections (39.34%) emerged as the major indications for SMA. Extended-spectrum penicillins (60.66%) were the most commonly used class of antibiotics for SMA. CONCLUSION: Our findings endorse high SMA prevalence among Indian medical students. Strict regulations on antibiotic sales and public education reinforced by strong antibiotic stewardship program at all levels are highly recommended.