Self-medication with antimicrobials in children: a study in tertiary care hospital, Odisha, India


  • Sristi Ganguly Department of Pediatrics, SVPPGIP, SCBMCH, Cuttack, Odisha, India
  • Kiran C. Pankaj Department of Pediatrics, Dr. B.R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India
  • Saroj K. Satpathy Department of Pediatrics, SVPPGIP, SCBMCH, Cuttack, Odisha, India



Antibiotics misuse, Antimicrobials in children, Self-medication


Background: Antimicrobial resistance is emerging as global threat to health, the injudicious use being linked to multiple reasons namely parental misconceptions, easy drug availability and previous experiences.  Children, due to frequent illnesses, are victims of this misuse and more than fifty percent of these drugs are self-medicated by caregivers. This study attempts to assess the trends associated with self-medication with antimicrobials in children and the factors associated with it.

Methods: This is a hospital based cross-sectional study, among pediatric outpatients aged 1 month to 14 years, in SCBMCH and SVPPGIP, Cuttack, during March 2019 to September 2019. A structured dichotomous questionnaire was administered to caregivers, including details of socio-demography and antimicrobials self-medicated. A pilot study was done for period of 1 month, and questionnaire accordingly modified. Data was analysed with Chi- square test and percentages, using SPSS 18.

Results: Among the 300 patients studied, prevalence of self-medication with antimicrobials was 21%. Most patients self-medicated on pharmacists’ advice (44.4%), commonest reason being similar illness previously (41.3%). Fever (31.7%) and cold cough (28.6%) were usual conditions, with Azithromycin being most frequently administered. 54% of cases self-medicating antimicrobials, had errors of dose or duration, with 27% reporting side-effects. Child’s age (p=0.042), father’s age (p=0.044), mother’s age (p=0.002), chronic illness in child (p=0.002) and type of family (p=0.011) were significantly associated with antimicrobial self-medication in children.

Conclusions: The high prevalence of self-medication with antimicrobials mandates need to educate parents and enforce laws regarding illegal dispensing of these drugs, to reduce the threat from resistance.


Slama TG, Amin A, Stephen Brunton SA, File TM Jr, Milkovich G, Rodvold KA, et al. A clinician's guide to the appropriate and accurate use of antibiotics: the Council for Appropriate and Rational Antibiotic Therapy (CARAT) criteria. Am J Med. 2005;118(Suppl7A):1S-6S.

Gold HS, Moellering RC. Antimicrobial-drug resistance. N Engl J Med. 1996;335:1445-53.

Mitsi G, Jelastopulu E, Basiaris H, Skoutelis A, Gogos C. Patterns of antibiotic use among adults and parents in the community: A questionnaire-based survey in a Greek urban population. Int J Antimicrob Agents. 2005;25(5):439-43.

Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20(4):373-80.

Cars O, Nordberg P. Antibiotic resistance - The faceless threat. Int J Risk Saf Med. 2005;17:103-10.

A World Health Organization resource: the role of pharmacist in self- care and self-medication (1998). Available at: Accessed 18 September 2019.

Donkor ES, Tetteh-Quarcoo PB, Nartey P, Agyeman IO. Self-medication practices with antibiotics among tertiary level students in Accra, Ghana: A cross-sectional study. Int J Environ Res Public Health. 2012;9:3519-29.

Rizwan KA. Self-Medication with Antibiotics: Practices among Pakistani Students in Sweden and Finland; PA 240, Södertörn University, Stockholm, 15:00 (English). Master Thesis. 2011:55.

Bi P, Tong S, Parton KA. Family self-medication and antibiotics abuse for children and juveniles in a Chinese city. Soc Sci Med. 2000;50:1445-50.

Togoobaatar G, Ikeda N, Ali M, Sonomjamts M, Dashdemberel S, Mori R, et al. Survey of non prescribed use of antibiotics for children in an urban community in Mongolia. Bull World Health Organ. 2010;88:930-6.

Abasaeed A, Vlcek J, Abuelkhair M, Kubena A. Self-medication with antibiotics by the community of Abu Dhabi Emirate, United Arab Emirates. J Infect Dev Ctries. 2009;3:491-7.

Gohar U F, Khubaib S and Mehmood A. Self-Medication Trends in Children by their Parents. J Develop Drugs. 2017:6:2

Mohanna M. Self-medication with Antibiotic in Children in Sana'a City, Yemen. Oman Med J. 2010;25(1):41-3.

Sharif SI, Masalmeh BE, Awad HM, Osama A, Abdulmgasood YA, Bugaighis LM. Parents’ knowledge and attitude to self-medication of children with antibiotics. Arch Pharma Pract. 2015;6:71-6.

Clarification on Pharmacy Practice Regulations, 2015 notified by Pharmacy Council of India in Gazette of India No.17 dt.16.1.2015. Avalaible at: Accessed 8 February 2020.

Sun C, Hu YJ, Wang X, Lu J, Lin L, Zohu X. Influence of leftover antibiotics on self-medication with antibiotics for children: a cross-sectional study from three Chinese provinces. BMJ. 2019;9:e033679.

Chang J, Lv B, Zhu S, Yu J, Zhang Y, Ye D, et al. Non-Prescription use of antibiotics among children in urban China: a cross-sectional survey of knowledge, attitudes, and practices. Expert Rev Anti Infect Ther. 2018;16:163-72.

Yu M, Zhao G, Lundborg CS, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis 2014;14.

Collett CA, Pappas DE, Evans BA, Hayden GF. Parental knowledge about common respiratory infections and antibiotic therapy in children. South Med J. 1999;92:971-6.

Suleman S, Ketsela A, Mekonnen Z. Assessment of self-medication practices in Assendabo town, Jimma zone, southwestern Ethiopia. Res Social Adm Pharm. 2009;5:76-81.

Saradamma RD, Higginbotham N, Nichter M. Social factors influencing the acquisition of antibiotics without prescription in Kerala State, south India. Soc Sci Med. 2000;50:891-903.

Sharif SI, Nassar AH, Al-Hamami FK, Hassanein MM, Elmi AH, Sharif RS. Trends of pediatric outpatients prescribing in Umm Al Quwain, United Arab Emirates. Pharmacol Pharm. 2015;6:9-16.

Parimi N, Pinto Pereira LM, Prabhakar P. Caregivers' practices, knowledge and beliefs of antibiotics in paediatric upper respiratory tract infections in Trinidad and Tobago: A cross-sectional study. BMC Fam Pract. 2004;5:28.

Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JG, Mechtler R, Deschepper R, Tambic-Andrasevic A, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12:452-9.

Panagakou SG, Papaevangelou V, Chadjipanayis A, Syrogiannopoulos GA, Theodoridou M, Hadjichristodoulou CS. Risk factors of antibiotic misuse for upper respiratory tract infections in children: results from a cross-sectional knowledge-attitude-practice study in Greece. ISRN Pediatr. 2012;2012:685302.

Alili-Idrizi E, Dauti M, Malaj L. Validation of the parental knowledge and attitude towards antibiotic usage and resistance among children in Tetovo, the Republic of Macedonia. Pharm Pract. 2014;12(4):467.

Organization W H. Ten threats to global health in. Available at: https://www. who. int/ emergencies/ ten- threats- to- globalhealth-in- 2019 Accessed 19 July 2019.

Bulario JS, Cruz ILP, Pilapil MC, Gutierrez MM. Factors Associated with Parental Self-medication of Antibiotics in Health Centers of Manila in 4th International Research Conference on Higher Education, KnE Social Sciences. 2018:891-910.

Kariyawasam, S. H. A Descriptive Cross sectional Study on Mothers Self-Medicating Children. Sri Lanka J Child Health. 2005:7-12.

Yu M, Zhao G, Lundborg CS, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Inf Dis. 2014:112.






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