Predictors of Antibiotic Self-Medication among Residents in the Western Area of Sierra Leone: A cross-sectional Population-based study

Self-medication with antibiotics (SMA) may result in inappropriate use with consequences such as adverse drug reactions, treatment failure, and bacterial antimicrobial resistance (AMR). This study aims to determine the prevalence and predictors of SMA among residents in the Western Area of Sierra Leone. This cross-sectional population-based study was conducted among residents in the Western Area of Sierra Leone. A total of 781 participants were selected using a two-stage stratified sampling method. Data were collected using a pre-tested, structured, interviewer-based questionnaire and analysis was done using descriptive statistics, binary logistic regression and Spearman’s rank correlation, with statistical significance set at p < 0.05. The prevalence of SMA was 87.5%. The most common reasons for SMA were the need for quick relief of symptoms (23.1%), non-serious disease (17.2%), and previous experience (15.8%). The most frequent complaints for SMA were common cold (19.6%), sore throat (15.8%), and cough (14.1%). Although 57.7% of participants had good knowledge about antibiotic and AMR, 79.0% and 92.1 % exhibited negative attitudes and poor practice regarding antibiotic use respectively. Secondary education (AOR=2.77, 95% CI: 1.23–6.23, p=0.014), being employed (AOR=3.19, 95% CI: 1.31–7.78, p=0.011) and overall poor practice (AOR=2.38, 95% CI: 1.22–4.63, p=0.011) were predictors of SMA. The high prevalence of SMA, coupled with negative attitudes and poor practices, highlights the need for targeted interventions to promote rational antibiotic use and combat antimicrobial resistance in Sierra Leone.