Self-medication with Antibiotics: Empirical Evidence from a Nigerian Rural Population

Background: Self-medication is a strong determinant of antimicrobial overuse as well as a causative of drug resistance. Irrational antibiotic use among patients has led to antibiotic resistance and serious health problem globally.

Objective: The objectives of the present study were to estimate the prevalence of self-medication with antibiotics in a sample of rural population presenting in primary health care centers in Northern Nigeria and evaluate socio-demographic factors associated with the practice.

Methods: This is a cross-sectional survey using a structured questionnaire to collect data from 1,150 randomly selected clinic attendees who visited the 25 Primary Health Centers in Niger State, Nigeria, between August 2014 and February 2015. Only participants who lived and reside in Niger State, Nigeria were enrolled into the study.

Results: In this study 602 men and 548 women, with mean age of 52.6±16.5 years actually participated. The prevalence of antibiotics self-medication was 82.2%. The major sources of antibiotic self-medication were drug stores (20.4%), chemist shops (58.2%) & pharmacy (10.9%). The antibiotics most frequently used for self-medication were ampicillin/ cloxacillin combination (24.1%), ampicillin (20.3%), sulfamethoxazole/ trimethoprim combination (14.2%), metronidazole (13.9%) and tetracycline (13.1%). Cough with productive mucus (30.1%), sore throat (23.7%), unremitting fever (20.7%), dysuria (10.6%) skin sepsis (7.5%), and vaginal discharge (7.4%) were the most frequent indications for the use of self-medicated antibiotics. The most important factors associated with self-medication were affordability (79.3%), accessibility 68.4% and application of previous prescriptions (60.4%).

Conclusion: Knowledge of antibiotics from rural population in Niger state, Nigeria is insufficient. Despite the open and rapid access to primary health care services, it appears that a high proportion of rural population in Niger state use antibiotics without medical prescription. More information about antibiotic use should be provided by physicians, pharmacists and chemists before prescribing and dispensing antibiotics. Self-medication with antibiotics is a serious problem in Nigeria and requires considerable attention.