Self-medication Behavior with antibiotics: a national cross-sectional survey in Sri Lanka

Antibiotic self-medication is common in low- and middle-income countries. This study aimed to evaluate the Sri Lankan public’s knowledge about and attitudes toward antibiotic use and self-medication, and factors associated with self-medication. A national cross-sectional, interviewer-administered, survey of a random household sample (N = 1100) was conducted. Factor analysis of the attitudinal items was conducted to investigate the factors associated with antibiotic self-medication. A response rate of ninety-one percent (n = 998) responded. Knowledge about antibiotics was poor (mean = 12.5; SD = 3.5; (scale 0–27)). Half had previously used an antibiotic once in the past three months. About 11% (108/998) had self-medicated the last time they took antibiotics; mostly obtained from a pharmacy (82%; 89/108). Three attitudinal factors were obtained, explaining 56.1% of the variance. Respondents were less likely to self-medicate if they did not support ease of access to antibiotics from pharmacies (psituational use of antibiotics (p= 0.001); supported appropriate use of antibiotics (p= 0.003); and had greater knowledge about prescription requirements for antibiotics (p= 0.004). There is limited knowledge about, and a high rate of self-medication with antibiotics.Factors contributing to self-medication could be addressed with appropriate public education campaigns, and policy changes.

抗生素自我用药在低收入与中等收入国家中较为普遍。本研究旨在评估斯里兰卡民众对抗生素使用及自我用药的认知与态度，并探究与抗生素自我用药相关的影响因素。研究采用随机家庭抽样方法，开展了全国性横断面访谈调查，初始样本量为1100例。本研究通过对态度条目进行因子分析，以明确抗生素自我用药的相关影响因素。本次调查的应答率为91%，有效应答样本量为998例。民众对抗生素的整体认知水平偏低（平均得分12.5，标准差3.5，评分范围0~27分）。近三个月内，有半数民众曾使用过抗生素；其中约11%（108/998）的民众在最近一次使用抗生素时采取了自我用药行为，此类药物中82%（89/108）购自药店。因子分析共提取出3个态度因子，累计解释总变异的56.1%。分析结果显示，若民众不支持从药店便捷获取抗生素（p=0.001）、认同抗生素合理使用原则（p=0.003），且对抗生素的处方要求具备更高认知水平（p=0.004），则其进行抗生素自我用药的概率显著更低。本研究表明，当前民众对抗生素的认知水平有限，且抗生素自我用药率较高。可通过开展针对性公众教育活动及调整相关政策，对影响抗生素自我用药的相关因素进行干预。