title: Self-medication practices with antibiotics among Chinese university students.
abstract: OBJECTIVE
  Self-medication with antibiotics (SMA) is a serious global health problem. We sought to investigate SMA behaviors and risk factors among Chinese university students, and further explore the association between SMA practices and adverse drug events (ADEs).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  An online survey was conducted at Jiangsu University (JSU) in eastern China in July 2011 using a pretested questionnaire.
  
  
  RESULTS
  Out of 2608 website visitors, 1086 participated in the survey (response rate: 41.6%), 426 respondents were excluded for not being a JSU student or repeat participation, 660 (2.2% of JSU students) were included in analysis, and 316 students (47.9%) had a lifetime history of SMA. Among self-treated students, 43.5% believed that antibiotic was suitable for viral infections, 65.9% had more than one SMA episode in the previous year, 73.5% self-medicated with at least two different antibiotics, 57.1% and 64.4% changed antibiotic dosage and antibiotics during the course, respectively. Female gender, older age, and prior knowledge of antibiotics (PKA) were identified as independent risk factors of SMA. There was no difference between students with and without PKA regarding SMA frequency, use of polyantibiotics, and switching antibiotic dosage or antibiotics. ADEs happened to 13.3% of self-medicated students. Frequent change of dosage and simultaneous use of the same antibiotic with different names were independent risk practices associated with an ADE.
  
  
  CONCLUSIONS
  Our findings substantiate high SMA prevalence among Chinese university students. Older age and PKA are independent SMA risk factors common to Chinese university students and female gender is exclusive SMA risk factor for JSU students. Poor SMA practices are associated with ADEs. Strict regulations on antibiotic sales and public education reinforced by further health care reform are recommended.
authors.affiliation: Medical Simulation Center, School of Clinical Medicine, Jiangsu University, Zhenjiang, Jiangsu, 212013, PR China. Electronic address: 372113325@qq.com.
authors.forename: X
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, 515041, PR China. Electronic address: michaelpan@stu.edu.cn.
authors.forename: H
authors.initials: H
authors.lastname: Pan
authors.affiliation: Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, 515041, PR China. Electronic address: fsyz30147@163.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Pediatric Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, PR China. Electronic address: binglincui@stu.edu.cn.
authors.forename: B
authors.initials: B
authors.lastname: Cui
authors.affiliation: Research Center of Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, PR China. Electronic address: danguizhang@stu.edu.cn.
authors.forename: D
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Shantou, Guangdong, 515041, PR China; Department of Microbiology and Immunology, Shantou University Medical College, Shantou, Guangdong, 515041, PR China. Electronic address: wbathein@stu.edu.cn.
authors.forename: W
authors.initials: W
authors.lastname: Ba-Thein
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012651:Self Medication / Q000523:psychology* / Q000706:statistics & numerical data*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Adverse drug event; Antibiotic; China; Self-medication; University student