Self-Medication and Its Contribution to Antibiotic Resistance: Insights from a Cross-Sectional Study Among Urban Households

Abstract

Background: Self-medication with antibiotics is an escalating public health concern, particularly in developing countries, contributing significantly to the global threat of antimicrobial resistance. Objective: This cross-sectional study aimed to assess the prevalence of antibiotic self-medication, identify commonly used antibiotics, and evaluate public awareness of antibiotic resistance among urban households in Khulna, Bangladesh. Methodology: A total of 300 adult participants were recruited from three major medical institutions in Khulna city between June 2023 to June 2024. Data was collected using a structured questionnaire, and analysis was performed with SPSS. Descriptive statistics and chi-square tests were used to identify associations, with p-values <0.05 considered statistically significant. Result: The study revealed a high prevalence of self-medication, with 72.0% of participants reporting antibiotic use without a prescription. The most common reason for not completing the full course was early symptom relief (57.9%). Metronidazole (38.0%) and Ciprofloxacin (26.9%) were the most frequently used antibiotics, primarily obtained from pharmacies without a prescription (58.3%). Awareness of antibiotic resistance was low; only 47.3% had heard of the term, and 37.3% believed that misuse contributes to resistance. A statistically significant association was observed between education level and self-medication practices (p = 0.032), with the highest prevalence among those with no formal education (85.7%) and the lowest among graduates or higher (76.9%). Conclusion: These findings highlight a high rate of unprescribed antibiotic use and a substantial lack of awareness regarding antibiotic resistance in urban Khulna. They underscore the urgent need for targeted public health interventions and stricter regulation of antibiotic sales to combat antimicrobial resistance effectively.