The DOI matches its Crossref record; 36 of the 38 references it cites were found in a registry or an index.
Self-medication with Antibiotics in WHO Southeast Asian Region: A Systematic Review
Open accessAbstract
Antibiotics are essential treatments, especially in the developing world like World Health Organization (WHO) Southeast Asian region where infectious diseases are still the most common cause of death. In this part of the world, antibiotics are purchased and used without the prescription of a physician. Self-medication of antibiotics is associated with the risk of inappropriate drug use, which predisposes patients to drug interactions, masking symptoms of an underlying disease, and development of microbial resistance. Antibiotic resistance is shrinking the range of effective antibiotics and is a global health problem. The appearance of multidrug-resistant bacterial strains, which are highly resistant to many antibiotic classes, has raised a major concern regarding antibiotic resistance worldwide. Even after decades of economic growth and development in countries that belong to the WHO Southeast Asian region, most of the countries in this region still have a high burden of infectious diseases. The magnitude and consequence of self-medication with antibiotics is unknown in this region. There is a need for evidence from well-designed studies on community use of antibiotics in these settings to help in planning and implementing specific strategies and interventions to prevent their irrational use and consequently to reduce the spread of antibiotic resistance. To quantify the frequency and effect of self-medication with antibiotics, we did a systematic review of published work from the Southeast Asian region.
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“Among the different channels from which patients in LMICs can access antibiotics, CDROs have been identified to be a predominant source of antibiotics for the wider population [19–22].”
From No prescription? No problem: drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries: a systematic review of qualitative studies (2021) · cites this paper as [21]
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In the citing paper
“This finding aligns with research by Gaurav Nepal et al, which reported that 79.6% of pharmacies in Nepal dispensed antibiotics for URI without a prescription. 17”
From Evaluation of antibiotic dispensing without prescription by community pharmacies: a simulated patient study (2025) · cites this paper as [17]
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Cites
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“It is a form of healthcare practiced in most parts of the world and overall 50% of total antibiotics used are purchased over-the-counter [4-5].”
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“Repercussions of selfmedication with antibiotics leading to health hazards, particularly in the developing world, are multifaceted as they are linked to poverty, inaccessibility, lack of medical professionals, poor quality of healthcare facilities, unregulated distribution of medicines, and patients’ misconceptions ab…”
BackgroundSelf-medication with Antimicrobial Drugs in Europe
Grigoryan, L., Haaijer‐Ruskamp, F. M., Burgerhof, J. G. M., Mechtler, R., Deschepper, R., Tambić-Andrašević, A., Andrajati, R., Monnet, D. L., Cunney, R., Matteo, A. D., et al. (2006) · Emerging infectious diseases · doi:10.3201/eid1203.050992 · Cited by 588 · cited 1×
“Developed countries, such as those of Europe where over-the-counter antibiotic sales are strictly regulated, have much lower prevalence rates of SMA, ranging from 1% to 4% [36].”
BackgroundOcan, M., Obuku, E. A., Bwanga, F., Akena, D., Richard, S., Ogwal-Okeng, J., & Obua, C. (2015) · BMC Public Health · doi:10.1186/s12889-015-2109-3 · Cited by 504
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“reported that the overall prevalence of self-medication varied from 19% to 82% in the Middle East [32].”
BackgroundAntimicrobial resistance in developing countries. Part II: strategies for containment
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“This, coupled with the high burden of infectious diseases in these countries, makes the private sector an important alternative source of healthcare [41].”
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“Introduction And Background Antibiotics are among the most commonly purchased drugs worldwide [1].”
BackgroundSelf-medication practice in Ethiopia: a systematic review
Ayalew, M. B. (2017) · Patient Preference and Adherence · doi:10.2147/ppa.s131496 · Cited by 182
Research works printed but not linked: 2
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Cited by
Sorted by citations
Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects
Uddin, T. M., Chakraborty, A. J., Khusro, A., Zidan, B. M. R. M., Mitra, S., Emran, T. B., Dhama, K., Ripon, M. K. H., Gajdács, M., Sahibzada, M. U. K., et al. (2021) · Journal of Infection and Public Health · doi:10.1016/j.jiph.2021.10.020 · Cited by 1,411
Baig, M. R., Al‐Worafi, Y. M., Alseragi, W. M., Ming, L. C., & Siddique, A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-819837-7.00025-x · Cited by 367
Endale, H., Mathewos, M., & Abdeta, D. (2023) · Infection and Drug Resistance · doi:10.2147/idr.s428837 · Cited by 348
“29 As documented by, 30 in the Southeast Asian region there is widespread usage of antibiotics without prescriptions from physicians (self-medication with antibiotics), increasing the likelihood of improper drug usage and subsequent appearance and distribution of drug-resistant microorganisms.”
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Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries
Godman, B., Egwuenu, A. J., Haque, M., Malande, O. O., Schellack, N., Kumar, S., Saleem, Z., Sneddon, J., Hoxha, I., Islam, S., et al. (2021) · Life · doi:10.3390/life11060528 · Cited by 244
Metadata
- Authors
- Nepal, G., & Bhatta, S.
- Affiliations
- Tribhuvan University (NP)
- Corresponding author
- Nepal, Gaurav
- ORCID
- Nepal, Gaurav
- Venue
- Cureus
- Published
- 2018-04-05
- Volume
- 10
- Issue
- 4
- Pages
- e2428-e2428
- ISSN
- 2168-8184 (ISSN-L)
- PMC
- PMC5988199
- OpenAlex
- W2796257797
- Cited by
- 272
- References
- 38
- Citations by year
- 2026: 6 · 2025: 36 · 2024: 35 · 2023: 55 · 2022: 42 · 2021: 43 · 2020: 31 · 2019: 23 · 2018: 1
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Cureus (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Keywords
- self-medication, antibiotics, antibiotic resistance, multidrug resistance, inappropriate medication use, community antibiotic use, Southeast Asia, infectious diseases, antimicrobial stewardship
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