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Table 1 Summary of included studies

From: The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis

Author/Date Country Objective Sample Size Prevalence CI Sources NPA Main findings
Abdulraheem, et al., 2016 [33] Nigeria - Rural To estimate the prevalence and identify factors associated with to SMA 150 63% 95% Drug stores
Remnant stock
Easy access to information from drug indices, medical literature and colleagues gives the sense of control. Misplaced lead to inappropriate self-medication.
Aditya, et al., 2013 [34] India – Urban To compare features of SMA among undergraduate dental students. 1150 82.2% 95% Pharmacy
Home cabinet
Level of education significantly influenced. Males more prone to self-medication than females. Economic factors – SMA is cheaper and affordable.
Albawani, et al., 2016 [41] Sana City - Yemen Rural/urban To determine the prevalence of SMA and its associated risk factors. 363 87.1% 95% Community drug dispensers
Remnant stock
Poor medication knowledge lack of awareness, Poor dispensing control
Bilal, et al.,2016 [30] Sindh City - Paquistan Rural To evaluate the prevalence and practice of self-medication with antibiotics 400 81.25% 95% Pharmacies
Corner stores
Home cabinet
Population, self-medicating had low level of education, with almost half of them uneducated, and mostly belonging to the low socioeconomic class.
Ramay, et al., 2015 [48] Guatemala-Rural/Urban To compare the magnitude of SMA and the characteristics of Those who self-medicate with antibiotics in four pharmacies 418 78% 95% Pharmacy
left over from previous prescriptions
Family member Friend
Publicity, Internet
Differences in socio-economic characteristics have been cited as a determinant for self-medication practices
Motives for SMA were centered on the cost of medical visits.
Ramay, et al., 2017 [31] Guatemala City Urban To understand the practice of SMA in four Guatemalan private pharmacies by comparing the characteristics of SMA in Guatemala, sources of information used, perceived effects of SMA and motives 230 79% 80% Pharmacies
Corner stores
From home (previously purchased)
Pharmacy employee
Family, Friend
High proportions of self-medication were similar in both
pharmacies, despite the differences in monthly income and educational
Israel, et al., 2015 [42, 49] Nigeria Urban To estimate the prevalence of SMA and evaluating the socio-demographic factors associated with the practice 471 93.9% NS family and friend’s leftovers
Community Pharmacy Hospital pharmacy
Respondents with higher educational level showed higher prevalence of SMA than those with lower educational qualification. SMA because of lack of funds to purchase drugs or pay hospital bills. Familiarity of the population to Beta lactam class this class of antibiotics could contribute to their misuse and abuse.
The high consultation of patent medicine dealers for drug and health information is appalling and should be discouraged.
Senadheera, G. et al., 2017 [45] Sri lanka - Rural To determine the period prevalence of SMA in the Colombo District and to describe the reasons for SMA, its utilization pattern and socio-economical determinants 431 80.4%. 95% Pharmacy
Left over
previous prescription
Given to another person
Left over from previous prescription
Contact in hospital
The study has provided data about the practice of SMA in Colombo district and identified an important area to be addressed in antibiotic stewardship programmes.
Sah, A. et al. 2016 [50] Nepal- Urban To estimate the prevalence of SMA among nursing students and evaluate factors associated. 500 91% 95% Previous experience of same illness
Seen previously doctor prescription
Advice from colleagues and seniors
It was reported using antibiotics for an inappropriate duration of time, and few of them knew the dosage of drugs used.
Shah, S. et al., 2014 [46] Pakistan – Urban To provide the prevalence of self-medication with antibiotics amongst the university students of Karachi. 431 80.4% NS NS The prevalence of self-medication with antibiotics among the non-medical university students was high despite the awareness of adverse effects. Antibiotic resistance was a relatively unknown terminology.
Shiavong, A. et al., 2017 [51] Laos- Urban/Rural To describe antimicrobial self-medication for reproductive tract infections (RTI) including sexually transmitted infections (STI), and to explore the understanding and use of health information among the adult population 500 91% NS Pharmacies,
Following previous treatment
Drug seller
More than three quarters of respondents, self-medicating for RTI/STI with antimicrobials, used inappropriate drugs bought from private pharmacies. There is a need to improve RTI/STI
management, including health promotion, through interventions at community level, and to health providers, including private drug sellers.
  1. NS Not specified
  2. Risk of bias assessment