A Multifaceted Analysis of Self-Medication With Antibiotics in South-East Delhi: A Mixed-Method Study Among Adults Who Self-Reported Antibiotic Use in the Past Three Months

Objectives The misuse of antibiotics fuels antimicrobial resistance (AMR), rendering treatments ineffective, increasing healthcare costs, and increasing mortality. This study estimated the prevalence, patterns, and drivers of self-medication with antibiotics (SMA) among adults, alongside exploring the reasons behind this practice. Methodology This community-based mixed-method study ran from January 2023 to June 2024. Simple random sampling selected 250 participants for the quantitative component, and purposive sampling chose 19 participants for the qualitative component. Descriptive statistics, cross-tabulation, and logistic regression were executed using SPSS (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp). Thematic analysis of focus group discussions (FGDs) was done using NVivo 14 (Lumivero 2023, <i>NVivo </i>Version 14, Denver). Results The prevalence of SMA was 36.4%(95% confidence interval (CI): 31.4-41.4), with 63 (69.2%) participants self-medicating at least once in the past three months, primarily for cold and flu-like symptoms (29, 31.86%) and fever (27, 29.69%). Key predictors of SMA were marital status, religion, education level, socioeconomic class, presence of chronic disease, knowledge, and attitude. Four (4.4%) participants experienced adverse drug reactions, 167 (66.8%) had inadequate knowledge about antibiotics, with only 13 (5.2%) aware of AMR, 142 (56.8%) had a favorable attitude towards SMA, and 171 (68.4%) followed appropriate practices. FGDs identified convenience, trust in local chemists, economic constraints, misinformation, long waiting times, limited healthcare access, and community acceptance as SMA drivers. Conclusion The study found that the prevalence of SMA in South-East Delhi surpasses rates in other regions of the country and signals a critical public health concern. To address SMA and mitigate AMR, authorities should enforce stricter regulations on over-the-counter antibiotic sales and implement targeted community education programs to enhance awareness of rational antibiotic use and AMR risks. These interventions, by improving regulatory oversight and knowledge, can effectively reduce SMA and safeguard antibiotic efficacy.