Background: Antibiotic self-medication constitutes a major public health challenge due to its substantial contribution to the emergence and dissemination of antimicrobial resistance (AMR). In Algeria, despite regulatory frameworks restricting antibiotic dispensation without prescription, the prevalence of this practice continues to rise, reflecting gaps in enforcement and public awareness.

Objective: The present study aims to investigate the prevalence, sociodemographic and behavioral determinants, and usage patterns associated with antibiotic self-medication within the general population of Algiers.

Methodology: A descriptive cross-sectional survey was conducted from April to June 2021 among 80 randomly selected individuals from four municipalities of Algiers. Data were collected using a structured questionnaire assessing sociodemographic characteristics, knowledge, attitudes, and practices regarding antibiotic use. Statistical analyses were descriptive.

Results: Among respondents, 63.7% reported self-medicating with antibiotics at least once during the previous 12 months. The main reasons for self-medication were previous medical experience (42.5%) and perceived mildness of symptoms (28.7%). Pharmacies were the main source of antibiotics without prescription (74%), followed by family and friends (15%). Amoxicillin and Amoxicillin–clavulanic acid were the most used antibiotics. Only 37% of respondents were aware of antibiotic resistance, and 52% did not complete their antibiotic courses.

Conclusion: The study reveals a high prevalence of antibiotic self-medication in Algeria, largely due to weak regulatory enforcement and unrestricted access to antibiotics. Strengthened antibiotic stewardship and targeted public awareness programs are urgently required to curb antimicrobial resistance.

Keywords: Self-medication, Antibiotics, Antimicrobial resistance, public health, Algeria

1. Fleming A. On the antibacterial action of cultures of a Penicillium, with special reference to their use in the isolation of B. influenzae. Br J Exp Pathol. 1929;10:226–236.
2. World Health Organization. Antimicrobial resistance: global report on surveillance. Geneva: WHO; 2020.
3. Centers for Disease Control and Prevention (CDC). Antibiotic resistance threats in the United States, 2023. Atlanta: U.S. Department of Health and Human Services; 2023.
4. Auta A, Hadi MA, Oga E, Adewuyi EO, Abdu-Aguye SN, Adeloye D, et al. Global access to antibiotics without prescription: a systematic review and meta-analysis. J Infect. 2019;78(1):8–18.
5. Grigoryan L, Monnet DL, Haaijer-Ruskamp FM, Bonten MJ, Lundborg S, Verheij TJ. Self-medication with antibiotics in Europe: a case for action. Curr Drug Saf. 2010;5(4): 329–332.
6. Torres NF, Chibi B, Middleton LE, Solomon VP, Mashamba-Thompson TP. Knowledge, attitudes and practices regarding antibiotics use among communities in Africa: a systematic review and meta-analysis. BMC Infect Dis. 2019;19(1):823.
7. Alhomoud F, Aljamea Z, Almahasnah R, Alkhalifah K, Basalelah L, Alhomoud FK. Self-medication and self-prescription with antibiotics in the Middle East: a review. 2017;6(2):37.
8. Napolitano F, Izzo MT, Di Giuseppe G, Angelillo IF. Public knowledge, attitudes, and experience regarding the use of antibio-tics in Italy. PLoS One. 2013;8(12):e84177.
9. Llor C, Bjerrum L. Antibiotic use in primary care and self-medication: European perspective. BMJ Open. 2014;4:e004477.
10. El-Hawy RM, Ashmawy MI, Abd Elrahman MT, Abdelrahman AM, Mohamed GM. Antibiotic self-medication among adult population in Egypt: a cross-sectional study. J Egypt Public Health Assoc. 2020;95(1):10.
11. Al Rasheed A, Yagoub U, Alkhashan H, Abdelhay O, Alawwad A, Al Aboud A, et al. Prevalence and predictors of self-medication with antibiotics in Saudi Arabia: a community-based survey. BMC Pharmacol Toxicol. 2016;17(1):51.
12. Ventola CL. The antibiotic resistance crisis: part 1 – causes and threats. Pharm Ther. 2015;40(4):277–283.
13. World Health Organization. Antibiotic resistance fact sheet. Geneva: WHO; 2022.
14. Boudjemaa R, Khelassi A, Hadjadj A, Djaballah-Ider F. Evaluation of antibiotic use and awareness of antimicrobial resistance in Algeria. Int J Pharm Pharm Sci. 2018;10 (9):34–40
15. Union Nationale des Opérateurs de la Pharmacie (UNOP). Sondage sur l’automé-dication en Algérie. Alger: UNOP; 2017
16. Klein EY, Van Boeckel TP, Martinez EM, Pant S, Gandra S, Levin SA, et al. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc Natl Acad Sci USA. 2018;115(15):E3463–E3470
17. Gajdács M, Paulik E, Szabó A. Pharmacist involvement in antimicrobial stewardship in community settings: a review of the evidence. Antibiotics. 2020;9(11):795.
18. Benlafquih C, Oumokhtar B, Touzani M, Rahou M, El Fakir S. Self-medication with antibiotics in Morocco: a cross-sectional study among the general population. Pan Afr Med J. 2021;38:150.
19. Bouharati I, Ait Messaoudene N, Merouani A. Antibiotic use and self-medication practices among patients in Constantine, Algeria. Algerian J Pharm Sci. 2019;5(2):45–52.
20. Chang J, Xu S, Zhu S, Li Z, Yu J, Zhang Y, et al. Prevalence and factors associated with self-medication with antibiotics among Chinese population: a nationwide cross-sectional survey. BMC Public Health. 2017;17:826.
21. Auta A, Banwat SB, David S, Dangiwa DA, Ogbole E, Tor-anyiin AJ. Antibiotic use in Nigeria: the impact of knowledge and attitudes on self-medication. J Infect Public Health. 2018;11(2):232–237
22. Awad A, Eltayeb I, Matowe L, Thalib L. Self-medication with antibiotics and role of pharmacists in Sudan. Pharm Pract (Granada). 2005;3(2):78–84.
23. Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self-medication with antibiotics in Jordanian population. Saudi Med J. 2007;28(6):911–918.
24. Hadi MA, Karami NA, Al-Muwalid AS, Al-Otabi A, Al-Subahi E, Bamomen A, et al. Community pharmacists’ knowledge, attitude, and practices toward dispensing antibiotics without prescription: a cross-sectional survey in Saudi Arabia. Pharmacy (Basel). 2016;4(4):38.
25. Abera B, Kibret M, Mulu W. Knowledge and beliefs on antimicrobial resistance among health professionals in Bahir Dar, Ethiopia. BMC Public Health. 2014;14:443.
26. Ocan M, Bwanga F, Bbosa GS, Bagenda D, Waako P, Ogwal-Okeng J, et al. Patterns and predictors of self-medication in northern Uganda. BMC Public Health. 2015;15:845.
27. Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;340:c2096.
28. Kotwani A, Wattal C, Joshi PC, Holloway K. Antibiotic use and resistance trends in India: a review. Indian J Med Res. 2016;144(5):687–693.
29. Ventola CL. The antibiotic resistance crisis: part 2 – management strategies and new agents. Pharm Ther. 2015;40(5):344–352.
30. World Health Organization. Global Action Plan on Antimicrobial Resistance. Geneva: WHO; 2015.
31. BOUDIA Fatma, DALI Ali Abdessemad, MEKAOUCHE Fatima Zohra Nadjet, FETATI Habiba, SENHADJI Imene, CHAIB Houria, TLEMCANI Mohamed, MIDOUN Nori, TOUMI Houari. Automédication et conseil pharmaceutique en période de pandémie de COVID-19 à Oran. ALGERIAN JOURNAL OF HEALTH SCIENCES. VOL. 03 NUM. 02 : 30–37.

Wefa Boughrara

Laboratoire de Toxicologie, Environnement et santé, LATES, USTO-MB, Oran, Université des Sciences et Technologie Oran-Mohamed Boudiaf USTO-MB, El Mnaouar, BP 1505, Bir El Djir 31000, Oran, Algeria