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ISSN No:2321 8630, V 1, I 1, 2014

Journal Club for Pharmaceutical Sciences (JCPS)


Manuscript No: JCPS/RES/2014/25, Received On: 18/09/2014 , Accepted On : 29/09/2014, Published On: 12/10/2014

RESEARCH ARTICLE
Self-Medication and Indiscriminate Use of Antibiotics Without
Prescription in Chennai, India: A Major Public Health Problem
1*

Nandakumar Ganesan, 2Siva Subramanian, 3Jaikumar, 4Harish Rawat, 5Senthil Kumar


1

Department of Public Health, Supreme Council of Health Doha, Qatar.


2
Pulla TKR College of Pharmacy, Hyderabad, AP
3
Sree Lakshmi Narayana Institute of Medical Sciences, Pondicherry, Tamilnadu
4
Tata consultancy services, Noida, New Delhi
5
Dept of Pharmacology, R.V.S College of Pharmaceutical Sciences, Coimbatore, Tamilnadu
ABSTRACT
To explore the use of self-medication with antibiotics among the general population in
Chennai in the state of Tamilnadu. A total of 1021 adults aged 18 and above were approached
and 781 subjects (76.4%) were participated in this study from the period of Jan - March 2014
in Chennai. Face to face interviews were conducted using a structured questionnaire to
collect data on the socio-demographic details, use of antibiotics, and self-medication with
antibiotics with or without prescription, source of antibiotics obtained and most common
symptoms/Disease for which antibiotics were frequently used. The prevalence of selfmedication with antibiotics in Chennai was 39.1%. Among the eligible representative sample
781, Males 424(54.3%) and females 357(45.7%) were reported the frequent use of selfmedication with antibiotics. The use of self-medication with antibiotics was found to be
statistically significantly associated with age, income. The major source of obtaining
antibiotics without medical prescription was the Pharmacy (P<0.001). Self-medication with
antibiotics is common and more prevalent among general population and it is recommended
that further research study is needed in this area to know more about it and to understand it
better. Doctors contribution and altitude is must for minimize or reduce the misuse of
antibiotics in the city of Chennai.
KEYWORDS
Prevalence, Antibiotics, Self-medication, Chennai, Cefuroxime
INTRODUCTION

penicillins, When penicillins was first

Alexander Fleming started the history of

introduced and used widely, and it was

antibiotics in the 1920s by discovery of

spoken as wonder drug, then penicillin was


used for much more infections caused by

Address for Correspondence:

Nandakumar Ganesan,
Department of Public Health, Supreme
Council of Health Doha, Qatar
Email: nkumar@sch.gov.qa,
nanda_genetics@yahoo.co.uk

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various organisms.1 In 1929, Alexander


Fleming said that, the time may come
when penicillin can be bought by anyone
from the medical shops, and when a man

130

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
who may gets under dose himself by
Thus, this study will provide an important
exposing his microbes to non lethal action

data regarding the self medication and use

of

more

of antibiotics without prescription among

Alexander

population. The result can be useful for

drugs

which

resistance.1

makes

According

them

to

Fleming suggestions, Antibiotics need to

developing

be prescribed in a judicious manner and

regarding

the

more

antibiotics

and

than

100

millions

outpatient

prescriptions are unnecessary.2 In early


stages, 70 & 80s study revealed that more
than 60% of the doctors/physician used
antibiotics to treat even common cold on
their patients. 3

policies

and

regulations

indiscriminate
other

use

of

medications

in

Chennai.
The prevalence of self-medication with
antibiotics was high in Chennai because,
this is the fact that not only Chennai, all
over India most of the drugs easily

Antibiotics can be defined as a

available or obtained from the community

substance derived from living organisms,

pharmacies and retail drug store without

usually bacteria or molds, and it is able to

valid medical prescription. As a result of

kill

their

this, minor ailments are often treated with

growth. In fact, the word antibiotic means

most powerful antibiotics. Despite the

life destroying. Whereas antibiotics were

introduction of essential drug list by world

originally grown from natural components

health organization (WHO) with concept

for the use of treatment of parasitic

of limited number of drugs supply for

diseases, today they are often synthetically

betterment of prescriptions and to reduces

produced

the cost of healthcare.5

microorganisms

infections.4

to

help

or

inhibit

combat

Self-medication

bacterial
can

be

defined as the use of drugs to treat self

METHODS

diagnosed symptoms or the intermittent or

This is prospective cross-sectional survey

continued use of prescribed medication for

based study on general population which

chronic or recurrent disease or symptoms. 5

included subjects aged between 18 -55

Data is not available from Chennai


regarding the level of self medication and
using antibiotics without prescription.
Although, pharmacies in Chennai are not
allowed to sell antibiotics without a valid
prescription by a licensed practitioner.

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years old. Participants who refused to


provide consent will be excluded from the
study and subjects were selected randomly
by

using

simple

random

sampling

technique. Data collection took place from


the period of three month between Jan March 2014. The questionnaires with a

131

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
letter of explanation, structured, validated
groups. Student-t test was used to ascertain
questionnaire were distributed to the

the significance of differences between

subjects studying in college and university

mean values of two continuous variables.

and general population. College and

The level P<0.05 was considered as cut-off

university students and general population

value for significance.

completed the questionnaires and returned


them to the interviewer. A total of 1021

RESULTS

populations were approached and 781

Table 1 shows the socio-demographic

subjects participated in the study giving a

characteristics of the studied subjects with

response rate of 76.4%.The questionnaire

and without self-medication. Overall mean

had three parts. The first part included the

age was 32.8 9.5 years old with 27.19.3

socio-demographic details of the studied

years old among self-medication group

subjects; the second part included the type

and 36.47.7 years old among non Self

of antibiotics used; Source of Obtaining

medication group, Among the studied

Antibiotics

Common

subjects 424(54.3%) were males while

Symptoms/Disease for which antibiotics

357(45.7%) were females. Males were

were self used. There is no ethical

more 271(88.0%) vs. 37(12.0%) in self-

clearance for the study was obtained

medication group while females were

because of this survey based study.

more 320(67.7%) Vs 153(32.3%) in non

Informed consent was obtained from

self- medication group (P<0.001). Most of

individual subject before each interview

the respondents were in the age group 26-

starts.

34 years (30.6%). The majority of them

and

The

statistical

analysis

was

performed by using the Statistical Package

were

for Social Sciences (IBM SPSS version

(28.6%), with middle level of income

19.0, SPSS Inc, Chicago, Illinois).The data

(42.9%) and the difference in educational

were collected and computed into SPSS

level, and occupation status was not

statistical

statistically

software.

Frequency

with

College/University

significant

education

between

self-

percentage will be calculated for all

medication and non self medication group

categorical

(P=0.583; P=0.139 respectively).

variables and

mean with

standard deviation for continuous scale


data. The Chi-square and Fishers exact
tests (two-tailed) were performed to test
for

differences

in

proportions

of

categorical variables between two or more

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Table 2 shows the Prevalence of SelfMedication with antibiotics according to


gender of the studied subjects. Prevalence
of

Ciprofloxacin,

Azithromycin

and

efaclor self-medication was higher among

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Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
studied male subjects as compared to
bactericidal action. Inappropriate use of
females (5.7%Vs1.7); 23.1%Vs16.5%) and

antibiotics may drug cause resistance,

21.7%Vs15.1%) respectively) with Values

adverse effects and may lift up the cost of

0.004, 0.022, and 0.019 respectively. In

the treatment.6

addition,

prevalence

of erythromycin,

Norfloxacin and Cefuroxime was higher


among females as compare to males
(P<0.001; 0.045 and 0.002).

In present study 39.1% of the subjects


practiced self-medication with antibiotics
without medical prescription within the
period of three month before the study

Table 3 and figure 1 shows the source of

starts. The excessive use of inappropriate

obtaining

common

and insufficient doses of antibiotics in

symptoms/Disease for which antibiotics

developing countries is a major public

were self-used. Difference between males

concern because it can lead to numerous

and

antibiotics

and

of

obtaining

complications to the society. 7 In Malta, the

common

medical

public perception towards antibiotics use

symptoms/Disease were higher significant

in the general population around 19.2 % of

with P<0.001 for each. Higher proportions

the

among males are obtaining antibiotics

prescription. 8 A similar study revealed in

from

Philippines, 66.2% of the cases were

females

antibiotics

in
and

Doctor/

terms

dentist

while

more

cases

took

without

proportions among females are obtaining

purchased

antibiotics from community pharmacies

prescriptions, mainly penicillin V was used

and friends. The commonest symptoms

among Filipino population.9 In another

among males for self-medication are cold

study reported from Vietnam ,cough

while on other hand toothache is the most

(34.1%),sore throat (32.0%)and diaherroea

common symptoms among females.

(8.8%) were treated by antibiotics without

DISCUSSION

antibiotics

medical

without

prescriptions ,even though patient does not


know what does it mean.10 In similar to

Use of self-medication with antibiotics

results of the study in Turkey11 with 45.8%

without valid medical prescription is a

of self medication with antibiotics and also

serious health problem which may leads to

in Jordan12 (40.7%) and other studies in

increases bacterial resistance and several

Sudan13 (48%), Lithuania14 (39.9) and

side effects. Antibiotics are the most

USA15 (43%), Mexico16 (5%), Finland17

powerful agents used for various bacterial

(28.1%) and finally Palestine18 (19.9%).

infections and acts as bacteriostatic and

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133

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
Table 1. Socio-demographics characteristics of the studied population according to the SelfMedication and Non-Self Medication (N=781)
Variable
Age (MeanSD)
Age Group
18-25 Years
26-34 Years
35-44 Years
45-54 Years
>55 Years
Sex
Male
Female
Education Level
Illiterate
Primary
Secondary
Diploma
College/university
Occupation
Not working
College student
Private officer
Govt officer
Business
Income/month*INR
<5000
5000-14,999
15000-19,999
>20000

Total N=781
n(%

Self-Medication
N=308 n(%)

Non-Self Medication
N=473 n(%)

P-Value

32.89.5

27.19.3

36.47.7

<0.001

242(31.0)
206(26.4)
204(26.1)
68(8.7)
61(7.8)

105(34.1)
84(27.3)
83(26.9)
21(6.8)
15(4.9)

137(29.0)
122(25.8)
121(25.6)
47(9.9)
46(9.7)

0.048

424(54.3)
357(45.7)

271(88.0)
37(12.0)

153(32.3)
320(67.7)

62(7.9)
220(28.2)
81(10.4)
191(24.5)

22(7.1)
89(28.9)
38(12.3)
71(23.1)
88(28.6)

40(8.5)
131(27.7)
43(9.1)
120(25.4)
229(29.0)

0.583

263(33.7)
138(17.7)
221(28.3)
101(12.9)
58(7.4)

103(33.4)
42(13.6)
92(29.9)
45(14.6)
26(8.4)

160(33.8)
96(20.3)
129(27.3)
56(11.80)
32(6.8)

0.139

131(16.8)
294(37.6)
208(26.6)
148(19.0)

50(16.2)
132(42.9)
90(29.2)
36(11.7)

81(17.1)
162(34.2)
118(24.9)
112(23.2)

<0.001

<0.001

*INR=Indian Rupees
Table 2. Prevalence of Self-Medication with antibiotics according to gender wise (N=781)
Antibiotics*
Amoxicillin
Augmentin
Ciprofloxacin
Doxycyline
Erythromycin
Azithromycin
Norfloxacin
Cefuroxime
Cefixime

Male N=424 n(%)


295(69.6%)
92(21.7)
24(5.7)
34(8.0)
190(44.8)
98(23.1)
109(25.7)
89(21.0)
137(32.3)

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Female N=357 n(%)


209(58.5)
54(15.1)
6(1.7)
15(4.2)
247(69.2)
59(16.5)
115(32.2)
109(30.5)
101(28.3)

P-Value
0.001
0.019
0.004
0.028
<0.001
0.022
0.045
0.002
0.224

134

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
* Multivariable dont add to100%
Table 3. Source of Obtaining Antibiotics and Common Symptoms for which antibiotics
were self Medicated (N=781)
Variable
Male N=424
Female N=357
P-Value
n(%)
n(%)
Source of Antibiotics
Prescription
Prescription from
Doctor/Physician
Prescription from Dentist
From Community Pharmacy
Friends
Common Symptoms
Coughs and sore throat
Cold and fever
Ear Infections
Flu conditions
Toothache

107(25.2)

75(21.0)

86(20.3)
190(44.8)
41(9.7)

38(10.6)
181(50.7)
63(17.6)

<0.001

51(12.0)
202(47.6)
52(12.3)
68(16.0)
51(12.0)

29(8.1)
131(36.7)
48(13.4)
71(19.9)
78(21.8)

<0.001

Figure 1. The most common medical symptoms or conditions for which antibiotics were selfmedicated (N=781)
50

47.6

Male

45
40

Female

36.7

35

30
25

21.8

19.9

20

16

12.3 13.4

15

12.1

12
8.2

10
5
0

Cold and
fever

Flu
conditions

Ear
Infections

Coughs
and sore
throat

Toothache

Common Symptoms

Excessive use of antibiotics may increase

disease. Most of the surgical methods and

antimicrobial resistance and the burden of

chemo therapies are not possible without

chronic disease and several side effects

antibiotics to fight against infection. These

and also lift up the cost of healthcare

are consequences please bear in mind

services. Without prescription, antibiotics

when use of antibiotics without valid

use will not be effective against infectious

medical prescription. However, no studies

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135

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
have been reported regarding misuse of
resistance.6 Improper use of antibiotics
antibiotics along with self-medication in

may increase the cost of treatment which

the

Chennai.

leads to prolongation of infections and, use

Therefore, the objective of the present

of antibiotics become ineffective for future

study was to determine the prevalence of

use on the certain bacterial disease. 7

state

of

Tamilnadu,

self-medication with antibiotics and its


possible impact on misuse of antibiotics
and other possible socio-demographic
factors.

There is several documented method to


prevent the inappropriate use of powerful
antibiotics, such as health education,
Doctor-patients

communication

and

Antibiotics meant for bacterial infection

changing or implementing the antibiotics

and mostly antibiotics misuse is caused by

policy.

lack of education or awareness campaign


etc. Improper use of antibiotics may
increase the bacterial resistance and
antibiotics

are

best

medication

for

bacterial infection and doctors/physician,


who knew that antibiotics are not effective
against viral infections. Most of the
antibiotics do not cure the common cold
because it is caused by virus not bacteria.
Most of doctors prescribing powerful
antibiotics when patients comes with mild
or moderate or severe cold with infections
,many antibiotics are misused because of
the patients does not adhere to doctors
/physician introductions and some of
patients going to pharmacies or retail drug
store asking antibiotics for common cold
or sore throat from pharmacist as a OTC
drugs.

These

kind

of

pharmacy

practices/physician or Doctor Practice may


result in the misuse of antibiotics and it
will leads to development of bacterial

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Health education is important contributing


factors for misuse of antibiotics. Health
education would be good measurement for
reducing

the

excessive

use

of

antibiotics19,20 and clinic and community


based health education method could be
more efficient in delivering messages to
public about inappropriate of use of selfmedication with antibiotics.21 Doctorpatients communication is also very good
effective method to reduce the antibiotics
misuse21

and

some

developing

organizational policies or implementing of


exist one, to support cautious use of
antibiotics21,22,

even

though;

some

organization and institution believes that a


computerized antibiotics therapy program
would improve the quality of the patient
care23

Although

implementing

the

antibiotics policy may decrease the misuse


of antibiotics

as well as increase the

patient satisfaction.

136

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
Misuse of antibiotics may be caused by
In present study shows that patients are
several causative factors, such as socio-

likely to follow this pattern from low

economic,

and

income population. The risks of buying

educational.23 In USA, Most of the

antibiotics without doctor prescription

pediatrician

parental

were associated with age, income, etc. The

pressure to prescribe non indicated use of

public perception of buying antibiotics

antibiotics.24

in

without prescription, it is more expensive

Kuwait city, half of the physicians are

to see or consult the doctor or physician

forced to prescribe the antibiotics by their

and very poor satisfaction with the

parents.25 Socio-economic status must be

medical practitioners in the Chennai city.

considered as an important factor for

The most common medical symptoms

influencing the rise of antibiotics misuse.

treated

25

respiratory

cultural,

cognitive

reported

Another

that,

study done

Use of self-medication with antibiotics

by

antibiotics
tract

were

infections

upper
(URTI)

without prescription from pharmacies or

particularly coughs and cold, sore throat

other

practice

with pharmacies about 47.5% of the cases.

throughout world, especially in developed

This present study clearly state that need

and developing countries,27 Availability of

for unlimited health education Campaigns

antibiotics without prescription, lack of

on proper use of antibiotics among the

regulation,

unrestricted

general population in Chennai city.

antibiotics

from

sources

pharmacist

are

are

common

access

pharmacies

dispensing

to
and

antibiotics

without known to the cause of infection,


27,28

these factors common for self-

medication with antibiotics. Moreover,


Self- medication is a significantly growing
public health problem in developed and
developing countries.27 Improper use of
antibiotics is presently one of the major
public health issues worldwide.

29,30,31

Besides, misuse of antibiotics was found


to be significantly common in children,
mainly

when

present

with

upper

respiratory tract infection (URTIs).27

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Powerful
cefatoxine,

antibiotics
cefdinor,

like

cefadroxyl,

cefetamet,

and

cefuroxyne, which are used for post


operative medication to treat the infections
in the body, which are being used
indiscriminately, resulting in severe health
problem to public who use the powerful
antibiotics.

Retail

pharmacist

or

community pharmacist are supposed to


dispense scheduled drugs only with valid
medical prescriptions which has been
prescribed

by

qualified

doctor

or

physician or consultant and pharmacist


who violate the such pharmacy law must

137

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
be punished on the spot. Self-medication
impact on misuse of antibiotics and other
with antibiotics has the potential hazard to
individual patients health as well as
public at huge level. This will create an
impact on antibiotics resistance health
related

problem,

our

present

study

revealed that immediate implementation


for public health education and the
enforcement of regulations regarding the
use of antibiotics without prescription in
Chennai.

possible socio-demographic factors.


However, present study was not a
population-based survey and as a result
was neither representative nor could
exclude sample bias. In addition, that study
did not discover the reasons of self
medication using antibiotics, which are
important for understanding such behavior.
The present study is the first populationbased survey in an urban area in Chennai

Limitations in This Study:

to estimate the prevalence, source of

The main limitation of this study is, its


cross sectional nature which have inherent
weakness in inferring causality. Also,
cross sectional survey are unable to
provide conclusive temporal association.
Therefore, results of this study should be
generalized with caution and failure to
evaluate all the risk factors and interview
all the population involved due to time
constraints.

obtaining

antibiotics

and

common

symptoms for which antibiotics were self


Medicated.
CONCLUSION
Chennai has a considerably high prevalence of
self-medication with antibiotics.

A strong

educational activity for the general public must


be initiated and doctors and physicians should
teach their patients not to use powerful
antibiotics without valid medical prescriptions

Although, this study only estimates the

for any conditions. Even though, the concern

prevalence

with

pharmaceutical regulatory authorities in the state

antibiotics with the patterns of utilization

pharmacy council must focus on the selling

of non-prescribed antibiotics. No such

antibiotics without prescription from pharmacy

studies have been documented regarding

store, as a result of public health problem owing

misuse of antibiotics along with self-

to the increase of misuse and

medication in the Chennai. Therefore, the

resistance. In such circumstances, penalties and

objective of the present study was to

imprisonment should be imposed on the retail or

determine

community pharmacists who

of

the

self-medication

prevalence

of

self-

medication with antibiotics and its possible

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bacterial

violate such

pharmacy laws.

138

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
REFERENCES
9. Lansang, M. A., Lucas-Aquino, R.,
1. Fleming, Alexander. (1947). Nobel
lecture on penicillin. PA Norstedt &

S., Juban, N., ... & Kunin, C. M.


(1990). Purchase of antibiotics without

Sner.
2. Staff writer. (2000). CDC Expands
Campaign Overuse of Antibiotics. June
01.
3. Soyka, L. F., Robinson, D. S., Lachant,
N., & Monaco, J. (1975). The misuse
of antibiotics for treatment of upper
respiratory tract infections in children.

4. Janet Zand., Paul M. Fleisis. (1992).


When your child needs antibiotics

5. World Health Organization. (2000).


the

regulatory

assessment of medicinal products for

Journal

of

choices
clinical

and

doses.

epidemiology,

43(1), 61-67.
10. Duong, D. V., Binns, C. W., & Le, T.
V. (1997). Availability of antibiotics as
overthecounter drugs in pharmacies:

Tropical medicine & international


health, 2(12), 1133-1139.

Limoncu, M., Ciceklioglu, M., & Eren,


S. (2003). Rational antibiotic use and
academic staff. International journal of
antimicrobial agents, 21(1), 63-66.

use in self-medication.
6. Eddie Hedrick., MS, MT. (2002).
(ASCP), CIC: Misuse of Antibiotics.
School of Health professions and
school of Medicine, University of

12. Sawair, F. A., Baqain, Z. H., Abu


Karaky, A., & Abu Eid, R. (2008).
Assessment

7. DSPRUD to tackle antibiotics OTC


sale under WHO programme, Pharma

of

self-medication

of

antibiotics in a Jordanian population.


Medical

Missouri, Columbia.

Principles

and

Practice,

18(1), 21-25.
13. Awad, A., Eltayeb, I., Matowe, L., &
Thalib, L. (2005). Self-medication with

Pulse, march 2005.


8. Borg, M. A., & Scicluna, E. A. (2002).
Over-the-counter

Inappropriate

11. Cagri Buke, A., Ermertcan, S., Hosgor-

Mothering. Fall.

for

prescription in Manila, the Philippines.

a threat to public health in Vietnam.

Pediatrics, 55(4), 552-556..

Guidelines

Tupasi, T. E., Mina, V. S., Salazar, L.

acquisition

of

antibiotics in the Maltese general


population. International journal of
antimicrobial agents, 20(4), 253-257.

antibiotics and antimalarials in the


community of Khartoum State, Sudan.
J Pharm Pharm Sci, 8(2), 326-331.
14. Berzanskyte,

Valinteliene,

R.,

Haaijer-Ruskamp, F., Gurevicius, R.,


&

Grigoryan,

medication

All Rights Reserved by Journals Club & Co.

A.,

L.

with

(2006).
antibiotics

Selfin

139

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
Lithuania. International journal of
21. Belongia, E. A., & Schwartz, B.
occupational

medicine

and

environmental health, 19(4), 246-253.

(1998).

Strategies

for

promoting

judicious use of antibiotics by doctors

15. Richman, P. B., Garra, G., Eskin, B.,

and patients. Bmj, 317(7159), 668-671.

Nashed, A. H., & Cody, R. (2001).

22. Radyowijati, A., & Haak, H. (2003).

Oral antibiotic use without consulting a

Improving antibiotic use in low-

physician: a survey of ED patients. The

income countries: an overview of

American

evidence

journal

of

emergency

medicine, 19(1), 57-60.

on

determinants.

Social

science & medicine, 57(4), 733-744.

16. Calva, J. (1996). Antibiotic use in a

23. Evans, R. S., Pestotnik, S. L., Classen,

periurban community in Mexico: a

D. C., Clemmer, T. P., Weaver, L. K.,

household and drugstore survey. Social

Orme Jr, J. F., ... & Burke, J. P. (1998).

science & medicine, 42(8), 1121-1128.

computer-assisted

management

17. Vnnen, M. H., Pietil, K., &

program for antibiotics and other

Airaksinen, M. (2006). Self-medication

antiinfective agents. New England

with antibioticsDoes it really happen

Journal of Medicine, 338(4), 232-238.

in Europe?. Health policy, 77(2), 166171.

Kleinman, K., Kotch, J., Schiff, N.,

18. Sawalha, A. F. (2008). A descriptive


study of self-medication
among

24. Huang, S. S., Rifas-Shiman, S. L.,

Palestinian

nonmedical

practices

medical

university

and

students.

Stille, C. J., ... & Finkelstein, J. A.


(2007).

Parental knowledge

about

antibiotic use: results of a clusterrandomized,

multicommunity

Research in Social and Administrative

intervention. Pediatrics, 119(4), 698-

Pharmacy, 4(2), 164-172.

706.

19. Green, R. J. (2006). Symptomatic

25. Sorkhou, I., Al-Qallaf, B., Hajiah, A.,

treatment of upper respiratory tract

Al-Sheibani, H., Bayoomi, A., &

symptoms in children: CPD. South

Mustafa, A. R. (2002). Perceptions of

African Family Practice, 48(4), p-38.

patients attending primary care in

20. Teng, C. L., Leong, K. C., Aljunid, S.

kuwait regarding upper respiratory

M., & Cheah, M. (2004). Antibiotic

tract

prescription in upper respiratory tract

Journal, 34(4), 272-275.

infections. Asia Pac Fam Med, 3(1-2),


38-45.

infections.

26. Kozyrskyj,

Kuwait

A. L., Dahl,

medical

M. E.,

Chateau, D. G., Mazowita, G. B.,


Klassen, T. P., & Law, B. J. (2004).

All Rights Reserved by Journals Club & Co.

140

Self-Medication and Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public Health
Problem
Evidence-based
prescribing
of
infection. Archives of disease in
antibiotics

for

children:

role

of

socioeconomic status and physician


characteristics.

Canadian

Medical

Association Journal, 171(2), 139-145.

childhood, 79(3), 225-230.


30. Kisuule, F., Wright, S., Barreto, J., &
Zenilman,

J.

antibiotic

(2008).

Improving

utilization

among

27. Bi, P., Tong, S., & Parton, K. A.

hospitalists: a pilot academic detailing

(2000). Family self-medication and

project with a public health approach.

antibiotics abuse for children and

Journal of Hospital Medicine, 3(1), 64-

juveniles in a Chinese city. Social

70.

science & medicine, 50(10), 14451450.

31. Grigoryan,

L.,

Burgerhof,

J.

G.,

Haaijer-Ruskamp, F. M., Degener, J.

28. Cebotarenco, N., & Bush, P. J. (2008).

E., Deschepper, R., Monnet, D. L., ...

Reducing antibiotics for colds and flu:

& Birkin, J. (2007). Is self-medication

with antibiotics in Europe driven by

student-taught

program.

Health

education research, 23(1), 146-157.


29. Fahey, T., Stocks, N., & Thomas, T.
(1998). Systematic review of the

prescribed
antimicrobial

use?.

Journal

chemotherapy,

of
59(1),

152-156.

treatment of upper respiratory tract

HOW TO CITE THIS ARTICLE


Ganesan, N., Subramanian, S., Jaikumar, Rawat, H., Kumar S. (2014). Self-Medication and

Indiscriminate Use of Antibiotics Without Prescription in Chennai, India: A Major Public


Health Problem. Journal Club for Pharmaceutical Sciences (JCPS), 1(I), 130-141.

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