Self-medication practices with antibiotics among tertiary level students in Accra, Ghana: a cross-sectional study
Open accessAbstract
The study was carried out to estimate the prevalence of self-medication with antibiotics among tertiary level students in Accra (Ghana) and evaluate factors associated with the practice. This was a descriptive cross-sectional study and involved face-to-face interviews of 600 respondents selected by convenient sampling. Prevalence of self medication was 70% (95% CI: 66.3-73.7), and the practice was significantly lower among medically inclined students (OR: 0.2, 95% CI: 0.1-0.4, p < 0.001). Among the respondents who practiced self medication, the most common frequency of antibiotic usage was at intervals of one month (30%, 95% CI: 25.6-34.4%), and the most common antibiotic used was amoxacillin (23.9%, 95% CI: 21.0-26.8%). Treatment failure were reported by 35% (95% CI: 30.5-39.6%) of the respondents, and the main reasons cited for self medication were that, it was less expensive compared to medical care in the hospital and secondly, medical care in hospitals were associated with long delays. Forty nine percent (95% CI: 44.2-53.8%) of the respondents had poor knowledge about the health implications of irrational use of antibiotics, and 46% (95% CI: 41.2-50.8%) did not comply with the completion of the full course of antibiotics. Self medication among tertiary students in Accra is an important public health problem and this may reflect the situation among tertiary students in the whole of Ghana.
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In a cross-sectional descriptive study by Donkor et al. in Ghana among tertiary students, 70% of participants reported self-medication with antibiotics.
“In a cross-sectional descriptive study conducted by Donkor et al. in Ghana among tertiary students, 70% of participants reported SMAs [7].”
From Understanding Antimicrobial Self-Medication Practices in the Andaman and Nicobar Islands in India (2025) · cites this paper as [7]
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Self-Medication Pattern among Social Science University Students in Northwest Ethiopia
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“Paralleling this, a high prevalence of self-medication with antibiotics among college students is reported in Ghana (70%) [4] and Iran (53%) [29].”
BackgroundResultInfluentialA systematic review of the literature on survey questionnaires to assess self-medication practices
Limaye, D., Limaye, V., Krause, G., & Fortwengel, G. (2017) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20173192 · Cited by 51 · see citing works
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Community acquired urinary tract infections among adults in Accra, Ghana
Donkor, E. S., Horlortu, P. Z., Dayie, N. T. K. D., Obeng‐Nkrumah, N., & Labi, A.-K. (2019) · Infection and Drug Resistance · doi:10.2147/idr.s204880 · Cited by 52 · see citing works
Padget, M., Guillemot, D., & Delarocque‐Astagneau, E. (2016) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2016.04.024 · Cited by 51 · see citing works
“A number of houses are selected randomly using a survey plan and houses are visited by field workers who ask residents about their antibiotic use [18,23,31,34–44].”
BackgroundSaha, A., Marma, K. K. S., Rashid, A., Tarannum, N., Das, S., Chowdhury, T., Afrin, N., Chakraborty, P., Emran, M. A., Mehedi, H. M. H., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0269622 · Cited by 50 · see citing works
“The study result was higher than most of the studies conducted on antibiotics self-medication such as India [14], Nigeria [59], Ghana [60], Greece [61], Tanzania [62], Jordan [63, 64], Sudan [65], Lithuania [66].”
ResultNdaki, P. M., Mwanga, J. R., Mushi, M. F., Konje, E. T., Mwita, S. M., & Mshana, S. E. (2025) · BMC Public Health · doi:10.1186/s12889-025-21553-6 · Cited by 49 · see citing works
Zeru, N., Fetene, D., Geberu, D. M., Melesse, A. W., & Atnafu, A. (2020) · Patient Preference and Adherence · doi:10.2147/ppa.s274634 · Cited by 52 · see citing works
Self-medication among rural residents in Lagos, Nigeria
Okafor, I. P., Ayanwale, M., & Odukoya, O. O. (2017) · Journal of Medicine in the Tropics · doi:10.4103/jomt.jomt_51_16 · Cited by 47 · see citing works
Sambakusi, C. S. (2019) · Malawi Medical Journal · doi:10.4314/mmj.v31i4.2 · Cited by 44 · see citing works
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Sridhar, S. B., Shariff, A., Dallah, L., Anas, D., Ayman, M., & Rao, P. M. (2018) · International Journal of Applied and Basic Medical Research · doi:10.4103/ijabmr.ijabmr_46_17 · Cited by 42 · see citing works
Rational Use of Drugs Among Inpatients and Its Association with Health Literacy
Abacıgil, F., Turan, S. G., Adana, F., Okyay, P., & Demirci, B. (2019) · Meandros Medical And Dental Journal · doi:10.4274/meandros.galenos.2018.35119 · Cited by 42 · see citing works
“Self medication with antibiotics was reported as 70% from senior university students in Ghana (20), and in a Malaysian study, antibiotics used without consulting to a physician for flu-like symptoms was 7.”
BackgroundInfluentialLerbech, A. M., Opintan, J. A., Bekoe, S. O., Ahiabu, M., Tersbøl, B. P., Hansen, M. A., Brightson, K., Ametepeh, S., Frimodt‐Møller, N., & Styrishave, B. (2014) · PLoS ONE · doi:10.1371/journal.pone.0113055 · Cited by 42 · see citing works
Gupta, Y., Kumar, R. N., Goyal, A., & Padhy, B. (2016) · Journal of Natural Science Biology and Medicine · doi:10.4103/0976-9668.184700 · Cited by 43 · see citing works
“8%).[18,25,26] The media coverage of emergence of New Delhi Metallo beta-lactamase-1 enzyme bearing bacteria, which are resistant to most of the known antibiotics; and its relation to India might have created awareness among medical students regarding proper use of antibiotics.”
BackgroundAlves, R., Precioso, J., & Becoña, E. (2020) · Nordic Studies on Alcohol and Drugs · doi:10.1177/1455072520965017 · Cited by 41 · see citing works
Kpokiri, E., Ladva, M., Dodoo, C. C., Orman, E., Aku, T. A., Mensah, A., Jato, J., Mfoafo, K., Folitse, I., Hutton-Nyameaye, A., et al. (2021) · medRxiv · doi:10.3390/antibiotics11010006 · Cited by 40 · see citing works
“This is consistent with other findings reported in Ghana [3,20,21].”
ResultXu, R., Mu, T., Wang, G., Shi, J., Wang, X., & Ni, X. (2019) · The Journal of Infection in Developing Countries · doi:10.3855/jidc.11359 · Cited by 40 · see citing works
“[31] Ghana Africa NA 300:300 600 Medical: 100”
MethodHelegbe, G. K., Aryee, P. A., Mohammed, B. S., Wemakor, A., Kolbila, D. Z., Abubakari, A.-W., Askanda, S., Alhassan, R., Barnie, C., Donkoh, A. A., et al. (2018) · Canadian Journal of Infectious Diseases and Medical Microbiology · doi:10.1155/2018/5610981 · Cited by 35 · see citing works
Self-Medication Practices among the Adolescent Population of South Karnataka, India
Mathias, E. G., D'Souza, A., & Prabhu, S. (2020) · Journal of Environmental and Public Health · doi:10.1155/2020/9021819 · Cited by 37 · see citing works
“)e studies on self-medication practices among medical students in Accra, Ghana, showed higher prevalence rates [10].”
BackgroundTohan, M. M., Ahmed, F., Juie, I. J., Kabir, A., Howlader, M. H., & Rahman, M. A. (2024) · Scientific Reports · doi:10.1038/s41598-024-60931-9 · Cited by 38 · see citing works
“Factors such as knowledge and literacy 24,26 , attitude 28,30 , and the convenience of self-medication 32,34 have a significant impact on self-medication practices.”
BackgroundColonization of HIV-Infected Children with Methicillin-Resistant Staphylococcus aureus
Donkor, E. S., Kotey, F. C. N., Dayie, N. T. K. D., Duodu, S., Tetteh‐Quarcoo, P. B., Osei, M., & Tette, E. M. A. (2019) · Pathogens · doi:10.3390/pathogens8010035 · Cited by 34 · see citing works
“[70], they reported that about 50% of the study respondents did not complete an antibiotic course.”
BackgroundEgyir, B., Obeng‐Nkrumah, N., & Kyei, G. B. (2020) · African Journal of Laboratory Medicine · doi:10.4102/ajlm.v9i1.1302 · Cited by 32 · see citing works
Rerambiah, L. K., Ndong, J.-C., Massoua, P. M. M., Medzegue, S., Elisee-Ndam, M., Ndong, A. M., & Siawaya, J. F. D. (2014) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2014.01.015 · Cited by 32 · see citing works
Antibiotic self-medication in university students from Trujillo, Peru
Núñez, M., Tresierra-Ayala, M. A., & Gil-Olivares, F. (2016) · Medicina Universitaria · doi:10.1016/j.rmu.2016.10.003 · Cited by 32 · see citing works
Valentin, B. C., Mboni, H. M., Amuri, B. S., Kamulete, G. S., Byanga, J. K., Duez, P., & Simbi, J.-B. L. (2015) · Pan African Medical Journal · doi:10.11604/pamj.2015.21.107.5651 · Cited by 31 · see citing works
The role of Sudanese community pharmacists in patients’ self-care
Mohamed, S. S.-E., Mahmoud, A. A., & Ali, A. A. (2014) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-013-9911-8 · Cited by 30 · see citing works
Dayie, N. T. K. D., Tetteh-Ocloo, G., Labi, A.-K., Olayemi, E., Slotved, H., Lartey, M. Y., & Donkor, E. S. (2018) · PLoS ONE · doi:10.1371/journal.pone.0206728 · Cited by 30 · see citing works
Jimah, T., Fenny, A. P., & Ogunseitan, O. A. (2020) · One Health Outlook · doi:10.1186/s42522-020-00021-8 · Cited by 30 · see citing works
A qualitative study on community use of antibiotics in Kinshasa, Democratic Republic of Congo
Shembo, A. K. P., Musumari, P. M., Srithanaviboonchai, K., Tangmunkongvorakul, A., & Dalleur, O. (2022) · PLoS ONE · doi:10.1371/journal.pone.0267544 · Cited by 30 · see citing works
Banerjee, I., Sathian, B., Gupta, R. K., Amarendra, A., Roy, B., Bakthavatchalam, P., Saha, A. C., & Banerjee, I. (2016) · Nepal Journal of Epidemiology · doi:10.3126/nje.v6i2.15165 · Cited by 33 · see citing works
Afriyie, D. K., Amponsah, S. K., Dogbey, J., Agyekum, K., Kesse, S., Truter, I., Meyer, J. C., & Godman, B. (2017) · Hospital Practice · doi:10.1080/21548331.2017.1348139 · Cited by 28 · see citing works
“We are aware that studies regarding antibiotic prescribing have been conducted in ambulatory care in Ghana, including self-medication, and there are also published studies monitoring antibiotic use and resistance patterns in Ghana [25-31].”
BackgroundPrevalence of self-medication in Ghana: a systematic review and meta-analysis
Opoku, R., Dwumfour-Asare, B., Agrey-Bluwey, L., Appiah, N. E., Ackah, M., Acquah, F., Asenso, P. F., & Issaka, A.-A. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-064627 · Cited by 30 · see citing works
Tettey, R., Egyir, B., Tettey, P., Arko‐Mensah, J., Addo, S. O., Owusu-Nyantakyi, C., Boateng, W., & Fobil, J. N. (2024) · PLoS ONE · doi:10.1371/journal.pone.0301531 · Cited by 29 · see citing works
Sharma, A., Oommen, S., Topno, I., & Saya, R. P. (2015) · Journal of Basic and Clinical Physiology and Pharmacology · doi:10.1515/jbcpp-2015-0025 · Cited by 28 · see citing works
Shitindi, L., Issa, O., Poyongo, B. P., Horumpende, P. G., Kagashe, G. A. B., & Sangeda, R. Z. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1301561 · Cited by 31 · see citing works
Aworh, M. K., Kwaga, J. K. P., & Okolocha, E. C. (2021) · One Health Outlook · doi:10.1186/s42522-021-00058-3 · Cited by 26 · see citing works
Ali, H. T., Barakat, M., Abdelhalim, A. R., Al-Kurd, I. N., Muhammad, M. K.-E., Sharkawy, M. M., Elbahnasawy, M. G., Amer, S. A., Self-Medication Collaborative Group, Masoud, M., et al. (2024) · BMC Public Health · doi:10.1186/s12889-024-17913-3 · Cited by 25 · see citing works
“The cautious nature of females, in contrast to males, can also have an important contributing role [30].”
Antibiotic resistance in toxigenic E. coli: a severe threat to global health
Biswas, S., Bal, M., Pati, S., Rana, R., Dixit, S., & Ranjit, M. (2024) · Discover Medicine · doi:10.1007/s44337-024-00102-x · Cited by 27 · see citing works
Mahazu, S., Sato, W., Ayibieke, A., Prah, I., Hayashi, T., Suzuki, T., Iwanaga, S., Ablordey, A. S., & Saito, R. (2022) · Scientific Reports · doi:10.1038/s41598-022-05869-6 · Cited by 25 · see citing works
Appiah, V. A., Pesewu, G. A., Kotey, F. C. N., Boakye, A. N., Duodu, S., Tette, E. M. A., Nyarko, M. Y., & Donkor, E. S. (2020) · Pathogens · doi:10.3390/pathogens9050329 · Cited by 25 · see citing works
“These rates are higher than those recorded in previous studies [35,39, 40,64], and may be due to the extensive marketing of antimicrobials and indiscriminate antibiotic use [54,55,72,73].”
ResultNursing students’ perceived consequences of self-medication: a qualitative study
Khatony, A., Soroush, A., Andayeshgar, B., & Abdi, A. (2020) · BMC Nursing · doi:10.1186/s12912-020-00460-8 · Cited by 24 · see citing works
Kretchy, J., Adase, S. K., & Gyansa‐Lutterodt, M. (2021) · Scientific African · doi:10.1016/j.sciaf.2021.e01006 · Cited by 24 · see citing works
Multidrug-Resistant Streptococcus pneumoniae Isolates from Healthy Ghanaian Preschool Children
Dayie, N. T. K. D., Arhin, R. E., Newman, M. J., Dalsgaard, A., Bisgaard, M., Møller, J. K., & Slotved, H. (2015) · Microbial Drug Resistance · doi:10.1089/mdr.2014.0314 · Cited by 22 · see citing works
“20,52 There is evidence that the usage of substandard antimicrobials, the practice of truncating antimicrobial chemotherapy because of a lack of financial resources, 53 and exposure to low concentrations of antimicrobials during treatment may induce anti-microbial stress, which can lead to genotypic…”
InfluentialTefera, T. K., Gedif, T., Andualem, T., & Aferu, T. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e08825 · Cited by 22 · see citing works
Urrunaga‐Pastor, D., Benites-Zapata, V. A., & Mezones‐Holguín, E. (2020) · F1000Research · doi:10.12688/f1000research.17578.2 · Cited by 22 · see citing works
Chen, J., Sidibe, A. M., Shen, X., Dao, K., Maiga, A., Xie, Y., & Hesketh, T. M. (2020) · Expert Review of Anti-infective Therapy · doi:10.1080/14787210.2021.1857731 · Cited by 21 · see citing works
“Another study found that misuse of antibiotics through self-medication is common among students in Accra, the capital of Ghana, whose prevalence of self-medication was 70% [38].”
BackgroundAnalisis Perilaku dan Faktor Penyebab Perilaku Penggunaan Antibiotik Tanpa Resep di Surabaya
Djawaria, D. P. A., Setiadi, A. P., & Setiawan, E. (2018) · Media Kesehatan Masyarakat Indonesia · doi:10.30597/mkmi.v14i4.5080 · Cited by 35 · see citing works
“terhadap 422 pelajar di Ghana juga menunjukkan bahwa 40,50% pasien melakukan swamedikasi antibiotik karena biaya yang lebih murah dan menghindari lamanya waktu yang dibutuhkan untuk memperoleh obat di pusat layanan kesehatan.(36) Penelitian ini memiliki keterbatasan yakni faktor penyebab penggunaan antibiotik tanpa re…”
BackgroundSampah, J., Owusu-Frimpong, I., Aboagye, F. T., & Owusu-Ofori, A. K. (2023) · PLoS ONE · doi:10.1371/journal.pone.0274156 · Cited by 20 · see citing works
Gunawardhana, C., Sakeena, M. H. F., & Sivayoganthan, C. (2015) · Tropical Journal of Pharmaceutical Research · doi:10.4314/tjpr.v14i4.23 · Cited by 21 · see citing works
Moise, K., Bernard, J. J., & Henrys, J. H. (2017) · Pan African Medical Journal · doi:10.11604/pamj.2017.28.4.12589 · Cited by 20 · see citing works
“This is consistent with findings from a study conducted in Ghana [9].”
ResultHertz, J. T., Madut, D. B., Tesha, R. A., William, G., Simmons, R., Galson, S. W., Maro, V. P., Crump, J. A., & Rubach, M. P. (2018) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1093/trstmh/try138 · Cited by 20 · see citing works
Self medication practice among urban slum dwellers in Udupi Taluk, Karnataka, India
V, P., Narayanan, P., & Guddattu, V. (2017) · International Journal of Pharmacy and Pharmaceutical Sciences · doi:10.22159/ijpps.2017v9i6.15950 · Cited by 19 · see citing works
Lamptey, D. (2018) · Journal of Intellectual Disability Research · doi:10.1111/jir.12545 · Cited by 19 · see citing works
Self Medication with Antibiotics among Medical and Pharmacy Students in North India
Pal, B., Murti, K., Gupta, A. K., Choudhury, U., Rastogi, M., Pandey, H., Lal, C. S., Pandey, K., & Das, P. (2016) · American Medical Journal · doi:10.3844/amjsp.2016.7.12 · Cited by 18 · see citing works
Dillard, L. K., Wu, C. Z., Saunders, J. E., & McMahon, C. M. (2021) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2021.10.004 · Cited by 18 · see citing works
Detection of Potential Drug-Drug Interactions for Outpatients across Hospitals
Yeh, Y.-T., Hsu, M.-H., Chen, C.-Y., Lo, Y.-S., & Liu, C. (2014) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph110201369 · Cited by 18 · see citing works
“Previous studies have found that patients who receive medical care from multiple health care providers, particularly from different hospitals, are more likely to suffer adverse drug reactions (ADRs) [7–10].”
BackgroundSelf-Medication among Adults in Minia, Egypt: A Cross Sectional Community-Based Study
Ghazawy, E. R. (2017) · Health · doi:10.4236/health.2017.96063 · Cited by 18 · see citing works
“Globally, nearly half of all medicines are unreasonably used, and self-medication with antibiotics constitutes a major public health problem due to the irrational medicine use [2].”
BackgroundDemissie, F., Ereso, K., & Paulos, G. (2022) · Drug Healthcare and Patient Safety · doi:10.2147/dhps.s325150 · Cited by 17 · see citing works
“Treatment failures with antibiotics will also bring about prolonged contagion, which further increases the communicable disease burden in the community and thus expose the entire population to the danger of acquiring a resistant strain of bacteria and pathogens like Multi-Drug Resistant TB which are becoming global pr…”
BackgroundAlzoubi, A., Nasor, E. M., Suliman, E. M., Alqaderi, N., Abbastanira, S. H. I., Abdi, S. A. H., Mustafa, S., & Kheirallah, K. A. (2023) · Patient Preference and Adherence · doi:10.2147/ppa.s405279 · Cited by 17 · see citing works
Methicillin-Resistant Staphylococcus aureus in Ghana: Past, Present, and Future
Donkor, E. S., Dayie, N. T. K. D., & Tette, E. M. A. (2019) · Microbial Drug Resistance · doi:10.1089/mdr.2018.0115 · Cited by 17 · see citing works
“Consequently, despite the high rates of antibiotic misuse in Ghana, the consumption rates of ceph-alosporin and fluoroquinolones are relatively lower, 58,59 resulting in the low MRSA prevalence observed.”
PARENTAL SELF MEDICATION OF ANTIBIOTICS FOR CHILDREN IN BAGHDAD CITY
Jasim, A. L. (2014) · International Journal of Pharmacy and Pharmaceutical Sciences · Cited by 16 · see citing works
National Action Plan on Antimicrobial Resistance: stakeholder analysis of implementation in Ghana
Jimah, T., & Ogunseitan, O. (2020) · Journal of global health reports · doi:10.29392/001c.13695 · Cited by 25 · see citing works
Prevalence, patterns and associated factors of self-medication among older adults in Ghana
Morgan, A. K., Arimiyaw, A. W., & Nachibi, S. U. (2023) · Cogent Public Health · doi:10.1080/27707571.2023.2183564 · Cited by 15 · see citing works
Evaluating self-medication practices in Ethiopia
Tadesse, Y. B., Kassaw, A. T., & Belachew, E. A. (2023) · Journal of Pharmaceutical Policy and Practice · doi:10.1186/s40545-023-00553-0 · Cited by 15 · see citing works
“[41] in Accra, Ghana, and [42] in the United Arab Emirates, where amoxicillin had a high prevalence rate of 46% in both countries.”
BackgroundRisk of Asymptomatic Bacteriuria among People with Sickle Cell Disease in Accra, Ghana
Donkor, E. S., Osei, J., Anim‐Baidoo, I., & Darkwah, S. O. (2017) · Diseases · doi:10.3390/diseases5010004 · Cited by 15 · see citing works
“Ampicillin has been on the Ghanaian market for a long time, and there is evidence of a high rate of misuse of this antibiotic [34].”
BackgroundParents' knowledge and attitude to self-medication of children with antibiotics
Sharif, S., Masalmeh, B. M., Osama, A., Bugaighis, L. M. T., Abdulmqasood, Y. A., & Awad, H. A. (2015) · Archives of Pharmacy Practice · doi:10.4103/2045-080x.166592 · Cited by 15 · see citing works
- Authors
- Donkor, E. S., Tetteh-Quarcoo, P. B., Nartey, P., & Agyeman, I. O.
- Affiliations
- University of Ghana (GH)
- Department of Microbiology, University of Ghana Medical School, Accra, Ghana
- Accra Technical University (GH)
- Corresponding author
- Donkor, Eric S.
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2012-10-05
- Volume
- 9
- Issue
- 10
- Pages
- 3519-3529
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC3509469
- OpenAlex
- W1988985355
- Cited by
- 225
- References
- 44
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 19 · 2023: 15 · 2022: 16 · 2021: 13 · 2020: 29 · 2019: 21 · 2018: 21 · 2017: 21 · 2016: 15 · 2015: 13 · 2014: 16 · 2013: 5
- FWCI
- 11.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Keywords
- self-medication, antibiotics, tertiary students, antibiotic misuse, amoxicillin, treatment failure, antibiotic course completion, inappropriate antibiotic use, medical students, health knowledge, Accra, Ghana
- MeSH terms
- Anti-Bacterial Agents, Cross-Sectional Studies, Female, Ghana, Humans, Male, Surveys and Questionnaires, Self Medication, Students, Universities
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