title: Is self-medication with antibiotics in Europe driven by prescribed use?
abstract: BACKGROUND
  Self-medication with antibiotics may increase the risk of inappropriate use and the selection of resistant bacteria. One of the triggers for using self-medication may be past experience with antibiotics prescribed by health professionals. We examined the association between prescribed use and self-medication with antibiotics.
  
  
  METHODS
  A population survey was conducted in 19 European countries, covering 15,548 respondents. Multinomial logistic regression analysis was used to study the relationship between prescribed use and self-medication for all symptoms/diseases and for upper respiratory tract infections (URTIs).
  
  
  RESULTS
  The association between prescribed use and self-medication was modified by source of self-medication, region in Europe and education. This association was consistently stronger for self-medication from leftovers than from other sources, primarily directly from a pharmacy. It was stronger also for respondents from Northern/Western Europe than respondents from Eastern Europe and Southern Europe and those with low education. Prescribed use for URTIs (minor ailments such as throat symptom, influenza, etc.) increased the likelihood of self-medication with leftover antibiotics for these symptoms/diseases in all European regions.
  
  
  CONCLUSIONS
  Our study shows consistent associations between prescribed use and self-medication with antibiotics from leftovers, but has not been able to support the hypothesis that self-medication from other sources than leftovers is triggered by earlier prescribed use. Preventing leftovers may be one effective way of preventing self-medication. This can be achieved by ensuring that the amount dispensed corresponds to the amount prescribed, by educating patients and by making doctors aware that prescribing for minor ailments may increase the risk of self-medication for such ailments.
authors.affiliation: Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. l.grigoryan@med.umcg.nl
authors.forename: Larissa
authors.initials: L
authors.lastname: Grigoryan
authors.forename: Johannes G M
authors.initials: JG
authors.lastname: Burgerhof
authors.forename: Flora M
authors.initials: FM
authors.lastname: Haaijer-Ruskamp
authors.forename: John E
authors.initials: JE
authors.lastname: Degener
authors.forename: Reginald
authors.initials: R
authors.lastname: Deschepper
authors.forename: Dominique L
authors.initials: DL
authors.lastname: Monnet
authors.forename: Antonella
authors.initials: A
authors.lastname: Di Matteo
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Scicluna
authors.forename: Ana-Claudia
authors.initials: AC
authors.lastname: Bara
authors.forename: Cecilia Stålsby
authors.initials: CS
authors.lastname: Lundborg
authors.forename: Joan
authors.initials: J
authors.lastname: Birkin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D006801:Humans; D016015:Logistic Models; D010353:Patient Education as Topic; D012651:Self Medication; D014552:Urinary Tract Infections / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents