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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Main Authors: Guo Huang, Pu Ge, Mengyun Sui, He Zhu, Sheng Han, Luwen Shi
Format: Article
Language:English
Published: MDPI AG 2025-07-01
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.
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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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