Factors Driving Self-medication with Antimicrobials in Karaikal, Puducherry, India

Aims: To determine factors driving individuals to self medicate with antimicrobials and to ascertain the prevalence and practice of consumption of nonprescribed antimicrobials in Karaikal district of union territory of Puducherry, India. Materials and Methods: A structured, validated questionnaire was used to collect data from 504 patients and their relatives visiting the General Hospital, Karaikal. A picture containing a collage of various commonly purchased antimicrobials were shown to the participants to help them recall their SMA in the past 6 months. Data analysis was performed using SPSS version 25. Bivariate and multivariate logistic regressions revealed factors affecting SMA. Results: One-third of the participants (33.9%) reported SMA in past 6 months with prevalence significantly affected by male gender (adjusted odds ratio [OR] = 1.83; 95% confidence interval [CI]: 1.2–2.79), a preference for SMA during minor illnesses (adjusted OR = 3.05; 95% CI: 1.77–5.25) and a history of SMA among family members (adjusted OR = 3.43; 95% CI: 2.16–5.43). The most commonly self-prescribed drug was amoxicillin (55.2%) and the antimicrobials were mostly obtained from pharmacies (91.8%). Self-prescribed antimicrobials were commonly used to treat cold, cough, and fever. Our participants had self-medicated with antimicrobials because they found it easier to do so (32.2%) and as it saved them time (35.7%) and money (32.2%). Conclusions: The prevalence of SMA was found to be high in Karaikal. This misuse of antimicrobials can be lowered by approaching societal-cultural practices through community education, the supply-demand chain through stricter regulations of pharmacies, and enforcing health policies for rational use of antimicrobials.