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Survey of non-prescribed use of antibiotics for children in an urban community in Mongolia
Open accessAbstract
OBJECTIVE: to estimate the prevalence and identify the determinants of non-prescription use of antibiotics for children in Mongolia. METHODS: a community-based cross-sectional survey was undertaken in 10 subdistricts in Ulaanbaatar, Mongolia's capital. We used a structured questionnaire to collect data from a random sample of 540 households with at least one child aged < 5 years. Logistic regression was used to identify factors associated with antibiotic misuse. FINDINGS: of 503 participating caregivers, 71% were mothers; 42.3% (95% confidence interval, CI: 37.8-46.9) of caregivers had used non-prescribed antibiotics to treat symptoms in their child during the previous 6 months. Symptoms commonly treated were cough (84%), fever (66%), nasal discharge (65%) and sore throat (60%). Amoxicillin was the most commonly used antibiotic (58%). Pharmacies were the main source (86%) of non-prescribed antibiotics. Non-prescribed use by mothers was significantly associated with keeping antibiotics at home (odds ratio, OR: 1.7; 95% CI: 1.04-2.79), caregiver self-medication (OR: 6.3; 95% CI: 3.8-10.5) and older child's age (OR: 1.02; 95% CI: 1.01-1.04). Caregivers with a better knowledge of antibiotics were less likely to give children non-prescribed antibiotics (OR: 0.7; 95% CI: 0.6-0.8). CONCLUSION: the prevalence of non-prescribed antibiotic use for young children was high in Ulaanbaatar. Because such use leads to the spread of bacterial resistance to antibiotics and related health problems, our findings have important implications for public education and the enforcement of regulations regarding the sale of antibiotics in Mongolia.
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“However, the prevalence in India falls below the rates observed in the Middle East (34%) [34] and specific countries like Jordan (39.2%) [37], Mongolia (42.3%) [38], Tanzania (47.7%) [39], and Yemen (60%) [40].”
From Prevalence and associated factors of self-medication with antibiotics among pediatric population in India: a systematic review and meta-analysis (2025) · cites this paper as [38]
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“Studies have shown that antibiotics are often improperly consumed with selfmedication in self-limiting situations such as colds and diarrheal diseases (14-17).”
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“An interesting example for this is Chile interventions which included strict restriction on over-the-counter sales of antibiotics and public education campaign which results in a significant decrease in antibiotic use [41,44]; on the other hand, South Korea followed another national policy in the form of banning docto…”
BackgroundFactors Influencing Self-Medication Among Students of University of Ghana, Legon
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ANALYSIS OF SELF MEDICATION PRACTICES; A DESCRIPTIVE CROSS SECTIONAL STUDY
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“Our findings were consistent with other studies in Saudi Arabia (Al-Shawi et al., 2018), Bahrain (James et al., 2006), Magnolia (Togoobaatar et al., 2010), Vietnam (Le et al., 2011), and China (Bi et al., 2000), in which less severe illnesses were the main reason for giving antibiotics to children.”
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Ulziibat, M., Buettcher, M., Altankhuyag, U., Chuluunbaatar, B., Mikhlay, Z., Sharav, C., Bira, S., Essig, S., Ritz, N., & Munkhuu, B. (2024) · Global Pediatric Health · doi:10.1177/2333794x241298801 · Cited by 1
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Gainullina, Y. (2015) · Annals of the Russian academy of medical sciences · doi:10.15690/vramn567
“сообщается, что более 40% детей в Монголии принимают антибиотики для лечения инфекций дыхательных путей при отсутствии медицинских предписаний [11].”
Alaswad, F. A., AlZahrani, F. M., Alomani, F. A., Alwohaibi, N. M., Almaimouni, A. A., Almannaa, A. A., Saeed, A. A. B., Alzwaid, A. A., & AlAdwanie, R. A. (2018) · The Egyptian Journal of Hospital Medicine · doi:10.21608/ejhm.2018.9848
Quiñones, C. J. A., Jiménez, P. M., Aquino, C. J. V., Contreras, C., & López, E. (2019) · Ciencia y Salud · doi:10.22206/cysa.2019.v3i1.pp51-57
Self-medication with oral antibiotics among University students in United Arab Emirates
Kubaisi, K. A., Stecroix, M. D., Vinson, D., Sharif, S. I., & Abduelkarem, A. R. (2021) · Tropical Journal of Pharmaceutical Research · doi:10.4314/tjpr.v18i6.26
“Such irresponsible use of nonprescribed antibiotics is a major global public health problem [5].”
BackgroundNavabi, A., Shamsi, M., Khorsandi, M., & Zamanian, M. (2020) · doi:10.21203/rs.3.rs-55486/v1
“Page 3/15 For example in studies in Mongolia revealed that parents gave medications to their children without a prescription for different reasons [11].”
BackgroundDrug allergy in chıldren: what is the actual frequency of drug allergies?
Dilber, D. H. (2022) · SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital · doi:10.14744/semb.2022.65642
“In the literature, ampicillin-sulbactam, amoxicillin-clavulonate, and cefaclor are reported as the most frequently preferred antibiotics by physicians and parents in childhood.[15-18] However, to obtain more accurate data, it is necessary to evaluate drug reactions under the conditions of equal number of prescriptions…”
BackgroundANALYSIS OF SELF MEDICATION PRACTICES
Humayun, S., Imran, W., Naheed, I., Javid, N., Hussain, M., & Azhar, M. (2016) · The Professional Medical Journal · doi:10.29309/tpmj/2016.23.05.1592
Prevalence and Risk Factors for Antibiotic Utilization in Chinese ChildrenPreprint
Guo, S., Sun, Q., Zhao, X., Shen, L., & Zhen, X. (2021) · Research Square · doi:10.21203/rs.3.rs-244798/v1
İzgi, A., Yılmaz, Z., Oğuz, E., & Koruk, İ. (2022) · Güncel Pediatri · doi:10.4274/jcp.2022.09581
Abraham, Z. S., Mahegaa, P., & Kahinga, A. A. (2023) · East African Health Research Journal · doi:10.24248/eahrj.v7i2.731
Paul, K. K., Maiti, A., Chaudhuri, S., Lahiri, M., & Chattopadhyay, B. (2024) · Sri Lanka Journal of Child Health · doi:10.4038/sljch.v53i1.10682
“Prior experience in dealing with similar ailment was the commonest cause for the practice among parents in our study, which is consistent with findings of recent studies in Iraq 21 and Mongolia 22 .”
ResultImplicancias metodológicas en el estudio de la automedicación en niños.
Ferrer, T. D., & Alazraqui, M. (2023) · Cultura y Droga · doi:10.17151/culdr.2023.28.36.3
Edessa, D., Assefa, N., Dessie, Y., Asefa, F., Dinsa, G., & Oljira, L. (2022) · Figshare · doi:10.6084/m9.figshare.21256636
Additional file 1 of Prevalence and risk factors for antibiotic utilization in Chinese children
Guo, S., Sun, Q., Zhao, X., Shen, L., & Zhen, X. (2021) · Figshare · doi:10.6084/m9.figshare.14714986
Edessa, D., Assefa, N., Dessie, Y., Asefa, F., Dinsa, G. D., & Oljira, L. (2022) · Figshare · doi:10.6084/m9.figshare.21256639
Edessa, D., Assefa, N., Dessie, Y., Asefa, F., Dinsa, G., & Oljira, L. (2022) · Figshare · doi:10.6084/m9.figshare.21256633
Kassié, D., Dama, E., Razafindrabesa, T., Harimanana, A. N., Ravololomihanta, V., Bonkoungou, I. J. O., & Rakotomanana, E. F. N. (2026) · BMC Public Health · doi:10.1186/s12889-026-26190-1
“In both areas, 21% of women obtained antibiotics from nonmedical sources, echoing evidence from other African countries that informal markets remain a significant supply channel [34, 35].”
Atem, T. D., Singh, R., Newbury-Birch, D., Pal, B., & Chaudhary, V. (2026) · BMC Pediatrics · doi:10.1186/s12887-025-06394-x
“This pattern is coherent with findings from studies in Mongolia [31] and Uganda [28], showing the widespread use of these antibiotics in low-and middle-income countries.”
Абдухалилова, Г. К., Otamuratova, N. K., Akhmedova, K. Y., Tadjieva, N. U., Ходиев, А. В., & Akhmedova, D. R. (2026) · Azerbajdžanskij medicinskij žurnal · doi:10.34921/amj.2026.2.015
Baye, F. D., Mekonnen, G. B., Ferede, Y. A., Tigabu, D., Abuhay, A. G., Bazezew, L. Y., & Asferie, W. N. (2026) · IJID Regions · doi:10.1016/j.ijregi.2026.100972
“[ 27 ], but, in Mongolia, sample size and study setting difference.”
Metadata
- Authors
- Togoobaatar, G., Ikeda, N., Ali, M., Sonomjamts, M., Dashdemberel, S., Mori, R., & Shibuya, K.
- Affiliations
- The University of Tokyo (JP)
- Venue
- Bulletin of the World Health Organization
- Publisher
- WHO Press
- Published
- 2010-12-01
- Volume
- 88
- Issue
- 12
- Pages
- 930-936
- ISSN
- 0042-9686 (ISSN-L)
- PMC
- PMC2995192
- OpenAlex
- W2158815913
- Cited by
- 199
- References
- 36
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 9 · 2023: 11 · 2022: 23 · 2021: 18 · 2020: 16 · 2019: 21 · 2018: 22 · 2017: 14 · 2016: 16 · 2015: 11 · 2014: 9 · 2013: 10 · 2012: 8
- FWCI
- 9.33
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Bulletin of the World Health Organization (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion, cc-by-nc-nd)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Asian Development Bank
- Ministry of Health, Labour and Welfare
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Keywords
- antibiotic misuse, children, self-medication, antibiotic knowledge, amoxicillin, pharmacy, antibiotic resistance, Ulaanbaatar, Mongolia
- MeSH terms
- Adult, Anti-Bacterial Agents, Child, Preschool, Cross-Sectional Studies, Nonprescription Drugs, Female, Humans, Infant, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Mongolia, Urban Population, Health Care Surveys, Young Adult
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