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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 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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Zhu, X., Pan, H., Yang, Z., Cui, B., Zhang, D., & Ba‐Thein, W. (2015) · Public Health · doi:10.1016/j.puhe.2015.04.005 · Cited by 103
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“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
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“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].”
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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
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“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 30
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
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
“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 28
Kretchy, J., Adase, S. K., & Gyansa‐Lutterodt, M. (2021) · Scientific African · doi:10.1016/j.sciaf.2021.e01006 · Cited by 24
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
“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
Urrunaga‐Pastor, D., Benites-Zapata, V. A., & Mezones‐Holguín, E. (2020) · F1000Research · doi:10.12688/f1000research.17578.2 · Cited by 22
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
“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
“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
Gunawardhana, C., Sakeena, M. H. F., & Sivayoganthan, C. (2015) · Tropical Journal of Pharmaceutical Research · doi:10.4314/tjpr.v14i4.23 · Cited by 21
Moise, K., Bernard, J. J., & Henrys, J. H. (2017) · Pan African Medical Journal · doi:10.11604/pamj.2017.28.4.12589 · Cited by 20
“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
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
Lamptey, D. (2018) · Journal of Intellectual Disability Research · doi:10.1111/jir.12545 · Cited by 19
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
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
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
“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
“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
“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
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
“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
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
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
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 17
“[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
“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
Metadata
- 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
- 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
- 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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