International Journal of Clinical Pharmacy

, Volume 36, Issue 5, pp 1039–1047 | Cite as

Assessing determinants of self-medication with antibiotics among Portuguese people in the Algarve Region

  • Isabel RamalhinhoEmail author
  • Clara Cordeiro
  • Afonso Cavaco
  • José Cabrita
Research Article


Background Misuse of antibiotics gives rise to numerous individual and societal problems, among which antimicrobial resistance is currently a major worldwide concern. Understanding cultural features in the public’s attitudes and behaviours regarding antibiotics and their use is a prerequisite to developing effective educational interventions. Objective To estimate the prevalence of self-medication with antibiotics and evaluate the predictive factors associated with such self-medication. Setting The general population, drawn from town halls, supermarkets, hotels, food malls, restaurants, sports groups and Senior Colleges. Methods A cross–sectional study was conducted by convenience sampling the adult population living in the Algarve, Portugal. The information about self-medication with antibiotics was assessed by using a validated self-administrated questionnaire. Factors associated with self-medication were identified through bivariate analysis and a logistic regression model. Results Of the 2,000 questionnaires distributed, 1,198 were returned, representing a response rate of 59.9 %. A total of 1,192 individuals were included in the study. The mean age was 46.6 ± 16.9 years and 48.7 % (95 % CI 46–52 %) were male. The majority of individuals said that they had returned the leftover antibiotics to the pharmacy for destruction. However, 268 respondents (22.5 %, 95 % CI 20–25 %) said they had disposed of their medication through the garbage or the sewage system. 218 respondents (18.9 %, 95 % CI 17–21 %) were assumed to have already taken antibiotics without a prescription and 267 (23 %, 95 % CI 21–25 %) reported having leftover antibiotics at home. The factors that influence self-medication with antibiotics were age; in particular, the risk is higher in the youngest group 18–34 years: OR 4.57 (95 % CI 2.23–9.39; p < 0.001), and in the 50–64 year group: OR 2.33 (95 % CI 1.08–5.03; p = 0.03); and the male gender: OR 2.88 (95 % CI 1.86–4.46; p < 0.001). The risk was lower in respondents who said that it was not easy to get antibiotics without a prescription: OR 0.07 (95 % CI 0.05–0.12; p < 0.001). Conclusion Non-prescription acquisition, age and gender could be determinants of self-medication with antibiotics among Portuguese people in the Algarve region.


Antibiotics Antimicrobial resistance Determinants of self-medication Drug use Non-prescription use Portugal 



The authors wish to thank the Editor J.W.F. van Mill and two anonymous reviewers for their helpful comments and suggestions. Thanks are due to the participants, to the institutions that collaborate in the study, to Cátia Sebastião and John Naysmith.


Isabel Ramalhinho received the grant SFRH/BD/60249/2009 from the Fundação para a Ciência e Tecnologia (FCT), Portugal. Research of Clara Cordeiro was partially funded by FCT, through the project PEst–OE/MAT/UI0006/2014.

Conflicts of interest

None to declare.


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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Isabel Ramalhinho
    • 1
    • 2
    Email author
  • Clara Cordeiro
    • 1
    • 3
    • 4
  • Afonso Cavaco
    • 2
    • 5
  • José Cabrita
    • 2
    • 5
  1. 1.Faculty of Science and TechnologyUniversity of AlgarveFaroPortugal
  2. 2.Faculty of Pharmacy, Research Institute for Medicines and Pharmaceutical Sciences (iMed.UL)University of LisbonLisbonPortugal
  3. 3.Centre for Social Studies (CES)University of AlgarveFaroPortugal
  4. 4.CEAUL-Center of Statistics and Applications, University of LisbonLisbonPortugal
  5. 5.Faculty of PharmacyUniversity of LisbonLisbonPortugal

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