Over-the-Counter (OTC) Antibiotic Use and Its Association with Drug Resistance: A Cross-Sectional Study
Abstract
Objective: To evaluate the prevalence of over-the-counter (OTC) antibiotic use in Delhi National Capital Region (NCR), assess its association with antimicrobial resistance (AMR), and identify determinants influencing public knowledge and attitudes toward antibiotic consumption.
Material and Methods: A cross-sectional survey was conducted from July to August 2024 among 300 adult residents of Delhi NCR. Participants completed a validated, self-administered questionnaire covering demographics, antibiotic usage patterns, awareness of AMR, and personal attitudes. Stratified random sampling ensured demographic diversity. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression, with significance set at p-value<0.05.
Results: A total of 62.0% of participants admitted to purchasing antibiotics without a prescription, with 40% selecting antibiotics based on prior experience. While 78.3% were aware of AMR, misconceptions persisted; 27.7% believed antibiotics could alter human genetics. Educational institutions were the most common source of AMR knowledge (67.0%). Respiratory infections were the leading reason for antibiotic use (66.3%). A majority (73.3%) believed that stricter regulation on OTC antibiotic sales is necessary, and 68.3% agreed that antibiotics should only be available via prescription.
Conclusion: Despite high AMR awareness, self-medication and OTC antibiotic use remain widespread in Delhi NCR, driven by convenience, cost, and prior experience. Public health strategies must focus on correcting misconceptions, strengthening regulations, and expanding access to affordable, physician-guided care to curb misuse and reduce resistance.
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