Antibiotic knowledge and self-medication practices in a developing country: A cross-sectional study

Published:January 12, 2017DOI:


      • This study evaluated the use of antibiotics without a medical prescription in a developed country.
      • Four hundred questionnaires were completed between November 2012 and January 2013.
      • Lower educational level and self-medication with antibiotics were significantly related (P = .036).
      • People with lower knowledge about antibiotics stopped antibiotics at the inappropriate time (P = .002).
      • Self-medication was highly correlated with the educational level and antibiotic knowledge.


      Self-medication is identified by the World Health Organization as a major factor leading to antibiotics overuse, misuse and resistance. This study's objectives were to evaluate the knowledge and self-medication with antibiotics in a sample of the population of Lebanon.


      This study surveyed a sample of adults (over 18 years of age) residing in 2 major cities in Lebanon about their knowledge and self-medication with antibiotics. Health care professionals were excluded from the study.


      Four hundred questionnaires were completed. Of the responders, 72% were between 18 and 45 years of age with an overall 86% having completed at least high school. For their knowledge about antibiotics, 61% thought that antibiotics should be taken for common cold and 83% knew that misuse of antibiotics could result in microbial resistance. Self-medication significantly correlated with a lower educational level (P = .036). Those with lower knowledge about antibiotics stopped antibiotics at the inappropriate time (P = .002). Socioeconomic status, gender and age did not correlate with self-medication.


      Self-medication was associated with a person's educational level and knowledge of antibiotics. Awareness campaigns and enforcing medication dispensing laws are needed in to avoid self-medication with antibiotics.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Centers for Disease Control and Prevention
        Antibiotics/antimicrobial resistance.
        (Available from) (Accessed September 20, 2015)
        • WHO
        WHO's first global report on antibiotic resistance reveals serious, worldwide threat to public health.
        (Available from) (Accessed September 20, 2015)
        • McNulty C.A.
        • Boyle P.
        • Nichols T.
        • Clappison P.
        • Davey P.
        Don't wear me out- the public's knowledge of and attitudes to antibiotic use.
        J Antimicrob Chemother. 2007; 59 (Epub 2007 Feb 16): 727-738
        • Grigoryan L.
        • Burgerhof J.G.
        • Degener J.E.
        • Deschepper R.
        • Lundborg C.S.
        • Monnet D.L.
        • et al.
        Determinants of self medications with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system.
        J Antimicrob Chemother. 2008; 61 (Epub 2008 Feb 22): 1172-1179
        • Skliros E.
        • Merkouris P.
        • Papazafiropoulou A.
        • Gikas A.
        • Matzouranis G.
        • Papafragos C.
        • et al.
        Self medication with antibiotics in rural population in Greece: a cross sectional multicenter study.
        BMC Fam Pract. 2010; 11: 58
        • Tesaf T.
        • Foltan V.
        • Langsadl L.
        • Binder R.
        Consumption of antibiotics and self medication within the Slovak Republic.
        Acta Fac Pharm Univ Comen. 2005; 52: 210-217
        • Al-Azzam S.I.
        • Al-Husein B.A.
        • Alzoubi F.
        • Masadeh M.M.
        • Al-Horani M.A.
        Self-medication with antibiotics in Jordanian population.
        Int J Occup Med Environ Health. 2007; 20: 373-380
        • Awad A.I.
        • Aboud E.A.
        Knowledge, Attitude and Practice towards Antibiotic Use among the Public in Kuwait.
        PLoS ONE. 2015; 10: e0117910
        • Barah F.
        • Gonçalves V.
        Antibiotic use and knowledge in the community in Kalamoon, Syrian Arab Republic: a cross-sectional study.
        East Mediterr Health J. 2010; 16: 516-521
        • Saleh N.
        • Awada S.
        • Awwad R.
        • Jibai S.
        • Arfoul C.
        • Zaiter L.
        • et al.
        Evaluation of antibiotic prescription in the Lebanese community: a pilot study.
        Infect Ecol Epidemiol. 2015; 5 (eCollection 2015): 27094
        • Farah R.
        • Lahoud N.
        • Saleh N.
        • Salameh P.
        Dispensing antibiotics by Lebanese pharmacists: a higher and lower socio-economic levels comparison.
        J Infect Public Health. 2015; 8: 37-46
        • Cheaito L.
        • Azizi S.
        • Saleh N.
        • Salameh P.
        Assessment of self-medication in population buying antibiotics in pharmacies: a pilot study from Beirut and its suburbs.
        Int J Public Health. 2014; 59 (Epub 2013 Aug 13): 319-327
        • Mouhieddine T.H.
        Assessing the Lebanese population for their knowledge, attitudes and practices of antibiotic usage.
        J Infect Public Health. 2015; 8: 20-31
        • Republic of Lebanon Ministry of Public Health
        Laws and regulations.
        (Available from) (Accessed November 10, 2016)
        • Araj G.F.
        • Avedissian A.Z.
        • Ayyash N.S.
        • Bey H.A.
        • El Asmar R.G.
        • Hammoud R.Z.
        • et al.
        A reflection on bacterial resistance to antimicrobial agents at a major tertiary care center in Lebanon over a decade.
        J Med Liban. 2012; 60: 125-135
        • Baroud M.
        • Dandache I.
        • Araj G.F.
        • Wakim R.
        • Kanj S.
        • Kanafani Z.
        • et al.
        Underlying mechanisms of carbapenem resistance in extended-spectrum ß-lactamase-producing Klebsiella pneumoniae and Escherichia coli isolates at a a tertiary care centre in Lebanon: role of OXA-48 and NDM-1 carbapenemases.
        Int J Antimicrob Agents. 2013; 41: 75-79
        • El-Herte R.I.
        • Kanj S.S.
        • Matar G.M.
        • Araj G.F.
        The threat of carbapenem-resistant enterobacteriaceae in Lebanon: an update on the regional and local epidemiology.
        J Infect Public Health. 2012; 5: 233-243
        • Pan H.
        • Cui B.
        • Zhang D.
        • Farrar J.
        • Law F.
        • Ba-Thein W.
        Prior knowledge, older age, and higher allowance are risk factors for self-medication with antibiotics among university students in Southern China.
        PLoS ONE. 2012; 7 (Published online 2012 Jul 20; PMCID: PMC3401104): e41314
      1. (Sovereign and investment reports; Lebanon country profile. Available from) (Accessed September 27, 2015)
        • Ammar A.
        Health system and reform in Lebanon.
        (Available from) (Accessed September 20)
        • Mainous 3rd, A.G.
        • Diaz V.A.
        • Carnemolla M.
        Factors affecting Latino adults' use of antibiotics for self-medication.
        J Am Board Fam Med. 2008; 21: 128-134
        • Landers T.F.
        • Ferng Y.H.
        • McLoughlin J.W.
        • Barrett A.E.
        • Larson E.
        Antibiotic identification, use, and self-medication for respiratory illnesses among urban latinos.
        J Am Acad Nurse Pract. 2010; 22: 488-495
        • Central Administration of Statistics
        Lebanese Central Statistical Agency report.
        (Available from) (Accessed November 20, 2016)