Prevalence and Factors Influencing Self-Medication with Antibiotics among Adult Outpatients Attending Kenyatta National Hospital

Abstract

There is a threat that infectious bacterial diseases are becoming incurable as a result of a growing resistance to antibiotics. Several studies suggest a causal relationship between the use of antibiotics and development of resistance and urge for a more restricted use. The inappropriate use of antibiotics for the treatment of infections is a worldwide problem that has implications on the cost of treatment and the development of resistant bacterial strains. Nevertheless to date, information on self-medication with antimicrobial drugs is limited since most studies have focused on clinician prescribing behaviour, yet antibiotic use can be as a result of self medication. Up to date no study has been done in Kenya on self-medication and sociodemographic factors associated with such use. The aim of this study was to determine the prevalence of self medication with antibiotics and the factors that play a role in it among adult outpatients aged 18 years and above attending Kenyatta National Hospital. A total of 370 outpatients were selected from all the 22 outpatient medical clinics through simple random sampling within a period of one month between 10th October and 10th November 2010. A pretested semi-structured questionnaire was used to collect data on socio demographic characteristics and self-medication within the last 12 months was collected. All the data analyses were done using SPSS v.10. The association between antibiotic use and independent covariates of interest were assessed using logistic regression model at p<0.05 level of significance. Out of the 370 study participants, 53.5% had self-medicated with at least one antibiotic. Of the self medicating group about 36% of them were storing antibiotics not currently in use. The most common illnesses for self-medication with antibiotics were cough (63.3%), sore throat (48.7%), stomach ache (31.2%) and dental pain (21.6%). The most common reasons for self-medication were to avoid a more serious infection (44.2%), avoidance to pay for the physician/tests (29.1%) and lack of time to visit a physician (11.6%). Amoxicillin was reportedly the most commonly self-medicated antibiotic (81.4%). Others were; cotrimoxazole 47.2% and co-amoxiclav 25.1%. The most common self-medicating age group was 25-29 years age group with 25.9% while the least self-usage of antibiotics was in those below 20 years with 3.5%. Being single, within 25-29 years age group, educational status of primary or lower, presence of a chronic illness, negative perception of health status and low income increased likelihood of self administration with antibiotics (p<0.05). The study indicated the need for policy enforcement regarding the sale of antibiotics without prescription and health education programs among the community to decrease the inappropriate use of antibiotics and self-medication.