Self-medication behaviour with antibiotics: a national cross-sectional survey in Sri Lanka.

BACKGROUND : Antibiotic self-medication is common in low- and middle-income countries. This study aimed to evaluate the Sri Lankan public's knowledge about and attitudes towards antibiotic use and self-medication, and factors associated with self-medication. METHODS A national cross-sectional, interviewer-administered, survey of a random household sample (N=1100) was conducted. Factor analysis of the attitudinal items was conducted to investigate the factors associated with antibiotics self-medication. RESULTS : A response rate of 91% (n=998) was obtained. Knowledge about antibiotics was poor (mean=12.5; SD=3.5; (scale 0-27)). Half of the respondents had previously used an antibiotic once in the past three months. About 11% (108/998) had self-medicated the last time they took antibiotics; mostly obtained from a pharmacy (82%; 89/108). Three attitudinal factors were obtained, explaining 56.1% of the variance. Respondents were less likely to self-medicate if they did not support ease of access to antibiotics from pharmacies (p<0.001) and situational use of antibiotics (p=0.001); supported appropriate use of antibiotics (p=0.003); and had greater knowledge about prescription requirements for obtaining antibiotics (p=0.004). CONCLUSION : There is limited knowledge about, and a high rate of self-medication with antibiotics in Sri Lanka. Factors contributing to self-medication could be addressed with appropriate public education, awareness campaigns, and policy changes.