Abstract
BACKGROUND: Self-medication with antibiotics (SMA) is increasingly occurring worldwide, yet it is a process that can lead to inappropriate use of antibiotics, with potentially multiple adverse consequences such as an increased risk of antibiotic resistance. OBJECTIVE: The objective of this study is to assess the prevalence of self-medication with antibiotics among the Chinese population and investigate the factors associated with this behavior. METHODS: A multi-stage sampling method was employed to carry out a national cross-sectional questionnaire survey among Chinese individuals aged 18 years and above from July 10, 2021, to September 15, 2021. Following the statistical analysis of the collected data, binary logistic regression was applied to identify the factors associated with respondents' self-medication with antibiotics. Model robustness testing was also performed using best subset regression. RESULTS: From a total of 11,031 questionnaires, 9,344 qualified samples were selected. The prevalence of self-medication with antibiotics among Chinese residents was found to be 34.63% (3,237/9,344). The most important factor considered in SMA was the advice of medical professionals, accounting for 89.00%, including recommendations from doctors (2,524/3,237, 77.97%) and pharmacists (1,905/3,237, 58.85%). The results of the binary stepwise logistic regression analysis showed that female, people older than 36 years, with higher education, had consumed alcohol in the past month, with mild depression, having residential or employee health insurance as the primary form of health coverage, having commercial insurance, having better family health status, and perceiving higher levels of social support were more likely to practice SMA (P < 0.05). Conversely, individuals diagnosed with major depressive disorder were found to be less likely to engage in self-medication with antibiotics (P < 0.05). The best subset regression method and stepwise regression method gave the same results. CONCLUSION: The SMA issue of Chinese residents is still relatively serious. Residents' SMA was associated with their demographic and sociological characteristics, depression, family health, and perceived level of social support. The primary consideration for resident SMA is the advice of medical staff. The problem of SMA in China should be improved through antibiotic management, education on antibiotic knowledge, and medical staff's correct guidance.