Antimicrobial self-medication among outpatients at a tertiary hospital in South-East Nigeria and its implications for antimicrobial stewardship and resistance control
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Antimicrobial self-medication (ASM) contributes substantially to inappropriate antimicrobial use and antimicrobial resistance (AMR), particularly in low- and middle-income countries. This study assessed the prevalence, patterns, predictors, knowledge, and attitudes regarding ASM among outpatients attending a tertiary hospital. Methods An analytical cross-sectional study was conducted among 440 outpatients attending Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria. Data was collected using a semi-structured interviewer-administered questionnaire. Descriptive statistics, Chi-square tests, and multivariable logistic regression were used for analysis at a 95% confidence level and p < 0.05. Results The mean age of respondents was 37.96 ± 11.78 years, and 54.3% were males. Antimicrobial use within the preceding six months was 83.6%, while 92.5% had practised ASM. Pharmacies and patent medicine vendors were the major sources of antimicrobial agents. Antimalarial agents, ciprofloxacin, ampicillin, and amoxicillin were the most used agents, mainly for fever, cough, headache, and sore throat. Although 57.3% demonstrated good knowledge, only 25.0% recognized that AMR can spread between people, and 20.0% considered the use of leftover antimicrobial agents appropriate. Long waiting times/delays (58.6%) and financial barriers (27.0%) were the main healthcare-access challenges. Respondents with secondary education were more likely to self-medicate (AOR = 5.575; 95% CI: 1.29–24.05), whereas those with excellent knowledge were less likely to do so (AOR = 0.230; 95% CI: 0.07–0.80). Conclusion ASM was highly prevalent and was influenced by healthcare-system barriers, non-prescription access to antimicrobial agents, and knowledge gaps. Strengthening antimicrobial stewardship education, enforcement of prescription-only policies, and healthcare access are essential to curb inappropriate antimicrobial use and AMR. Clinical Trial Registration Clinical trial number: Not applicable. This study was an observational cross-sectional survey and did not involve a clinical trial or any intervention requiring trial registration.
Source: Discover Public Health
Institution: Alex Ekwueme Federal University, Ndufu-Alike
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7164893533