Understanding the Determinants Influencing Self-Medication with Antibiotics Among Malaysian Residents: A Qualitative Study to Inform Preventive Public Health Strategies

Abstract

Introduction: Self-medication with antibiotics (SMA)—the use of these drugs without a physician’s diagnosis, supervision, or a medical prescription—has emerged as a significant crisis in many societies, being a particular concern in low- and middle-income countries. SMA practices hinder global efforts to reduce antibiotic consumption in the human health sector and to control antimicrobial resistance (AMR). The aims of the study were to explore the motivations, perspectives, and personal experiences of the Malaysian population related to SMA, analyzing their subjective viewpoints, attitudes, and behaviors. Methods: The present qualitative study applied an interpretivism paradigm to explore the complex topic of SMA; the interview questions were developed and confirmed by experts in AMR and pharmacy practice. Qualitative data analysis was carried out through a thematic approach. Results: Out of twenty-seven (n = 27) eligible individuals, eleven (n = 11) agreed to participate in in-depth interviews. Three main themes and seven subthemes were identified. Participants revealed directly purchasing antibiotics from pharmacies, due to doctors prescribing similar medications for comparable illnesses in the past. Trust issues related to physicians prescribing unnecessary additional medications and suspected personal motives were revealed. Budgetary constraints, timesaving, and aspects of self-care were identified as some of the key drivers for SMA. Conclusions: The current study’s findings contribute to the understanding of the complexities surrounding SMA and provides insights into the public perceptions and behaviors regarding unregulated antibiotic use in Malaysia. Understanding these dynamics may inform targeted public health interventions to address SMA to mitigate the development of AMR.

Keywords

• self-medication
• antibiotics
• non-prescription
• antibiotic consumption
• antimicrobial resistance
• qualitative study