Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents
Antimicrobial resistance (AMR) represents a critical global health threat, with inappropriate antibiotic self-medication (ASM) being a key contributor. China—as the world’s largest antibiotic consumer—faces significant challenges despite regulatory efforts, compounded by limited contemporary data du...
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| Format: | Article |
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MDPI AG
2025-07-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/14/7/701 |
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| author | Guo Huang Pu Ge Mengyun Sui He Zhu Sheng Han Luwen Shi |
| author_facet | Guo Huang Pu Ge Mengyun Sui He Zhu Sheng Han Luwen Shi |
| author_sort | Guo Huang |
| collection | DOAJ |
| description | Antimicrobial resistance (AMR) represents a critical global health threat, with inappropriate antibiotic self-medication (ASM) being a key contributor. China—as the world’s largest antibiotic consumer—faces significant challenges despite regulatory efforts, compounded by limited contemporary data during the COVID-19 pandemic. A nationwide cross-sectional study was conducted using the 2021 China Family Health Index Survey (<i>n</i> = 11,031 participants across 120 cities). Trained investigators administered face-to-face questionnaires assessing ASM practices, decision-making factors, and sociodemographic characteristics. Multivariate logistic regression identified determinants of ASM. Overall, ASM prevalence was 33.7% (<i>n</i> = 3717), with no urban-rural difference (<i>p</i> > 0.05). Physician advice (78.2%), drug safety (67.1%), and efficacy (64.2%) were primary selection criteria; rural residents prioritized drug price and salesperson recommendations more than their urban counterparts (<i>p</i> < 0.01). Key predictors included higher ASM odds among females (OR = 1.30, 95%CI:1.18–1.43), middle-aged adults (46–59 years; OR = 1.20, 95%CI:1.02–1.42), those with health insurance (resident: OR = 1.33; commercial: OR = 1.62), and individuals with drinking histories (OR = 1.20, 95%CI:1.10–1.31). Lower odds were associated with primary education (OR = 0.69, 95%CI:0.58–0.81), unemployment (OR = 0.88, 95%CI:0.79–0.98), and absence of chronic diseases (OR = 0.56, 95%CI:0.47–0.67). One-third of Chinese residents engaged in ASM during the pandemic, driven by intersecting demographic and behavioral factors. Despite converging urban-rural prevalence rates, distinct decision-making drivers necessitate context-specific interventions, including strengthened pharmacy regulation in rural areas, tailored education programs for high-risk groups, and insurance system reforms to disincentivize self-medication. |
| format | Article |
| id | doaj-art-c54b805f37cc419b98c65bfe7c3a5f67 |
| institution | DOAJ |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj-art-c54b805f37cc419b98c65bfe7c3a5f672025-08-20T03:13:41ZengMDPI AGAntibiotics2079-63822025-07-0114770110.3390/antibiotics14070701Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese ResidentsGuo Huang0Pu Ge1Mengyun Sui2He Zhu3Sheng Han4Luwen Shi5Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, ChinaSchool of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, ChinaDivision of Chronic Non-Communicable Diseases and Injury Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 201106, ChinaDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, ChinaDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, ChinaDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, ChinaAntimicrobial resistance (AMR) represents a critical global health threat, with inappropriate antibiotic self-medication (ASM) being a key contributor. China—as the world’s largest antibiotic consumer—faces significant challenges despite regulatory efforts, compounded by limited contemporary data during the COVID-19 pandemic. A nationwide cross-sectional study was conducted using the 2021 China Family Health Index Survey (<i>n</i> = 11,031 participants across 120 cities). Trained investigators administered face-to-face questionnaires assessing ASM practices, decision-making factors, and sociodemographic characteristics. Multivariate logistic regression identified determinants of ASM. Overall, ASM prevalence was 33.7% (<i>n</i> = 3717), with no urban-rural difference (<i>p</i> > 0.05). Physician advice (78.2%), drug safety (67.1%), and efficacy (64.2%) were primary selection criteria; rural residents prioritized drug price and salesperson recommendations more than their urban counterparts (<i>p</i> < 0.01). Key predictors included higher ASM odds among females (OR = 1.30, 95%CI:1.18–1.43), middle-aged adults (46–59 years; OR = 1.20, 95%CI:1.02–1.42), those with health insurance (resident: OR = 1.33; commercial: OR = 1.62), and individuals with drinking histories (OR = 1.20, 95%CI:1.10–1.31). Lower odds were associated with primary education (OR = 0.69, 95%CI:0.58–0.81), unemployment (OR = 0.88, 95%CI:0.79–0.98), and absence of chronic diseases (OR = 0.56, 95%CI:0.47–0.67). One-third of Chinese residents engaged in ASM during the pandemic, driven by intersecting demographic and behavioral factors. Despite converging urban-rural prevalence rates, distinct decision-making drivers necessitate context-specific interventions, including strengthened pharmacy regulation in rural areas, tailored education programs for high-risk groups, and insurance system reforms to disincentivize self-medication.https://www.mdpi.com/2079-6382/14/7/701antibiotic self-medicationantimicrobial resistancedeterminantsdistributionChina |
| spellingShingle | Guo Huang Pu Ge Mengyun Sui He Zhu Sheng Han Luwen Shi Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents Antibiotics antibiotic self-medication antimicrobial resistance determinants distribution China |
| title | Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents |
| title_full | Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents |
| title_fullStr | Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents |
| title_full_unstemmed | Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents |
| title_short | Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents |
| title_sort | distribution and determinants of antibiotic self medication a cross sectional study in chinese residents |
| topic | antibiotic self-medication antimicrobial resistance determinants distribution China |
| url | https://www.mdpi.com/2079-6382/14/7/701 |
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