Knowledge of and attitude towards self-medication with antibiotics among general public in Kathmandu valley, Nepal: A cross-sectional survey


  • Parishan Shrestha College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
  • Peerasak Chantaraprateep College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
  • Wandee Sirichokchatchawan College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand


Antibiotics, Self-medication, Antibiotic resistance, Nepal


Purpose - The inappropriate use of antibiotics has led to development and spread of bacterial resistance globally resulting in thousands of deaths every year. This study was designed to study the knowledge, attitude and practice of self-medication with antibiotics among the general public in Kathmandu.

Design/methodology/approach - A cross-sectional survey was conducted during the month of May, 2018 among general public of Ward number 16, Kathmandu Metropolitan City, Nepal by random sampling. Chi-square test was performed to determine the association between general characteristics and level of knowledge, attitude and practice. Bivariate logistic regression was also used to determine associated factors.

Findings - Out of 437 participants, 31.1% had poor knowledge on antibiotics, and 16.2% had poor attitude. Gender, education, employment status, occupation, and income were associated with level of knowledge. Education, employment status, and occupation were associated with level of attitude at 95% confidence interval. Being male, education of high school or lower, being self-employed and low income were statistically significant with poor knowledge (p-value < 0.05). Educational accomplishment of high school or lower, with employment, and being self-employed were found to be independently associated with poor attitude (p-value < 0.05).

Originality/value - The study provides a baseline information on the knowledge of and attitude towards antibiotics and serves as a basis for designing intervention program as well as conducting future research.


Download data is not yet available.


1. World Health Organization [WHO]. What is antimicrobial resistance? [cited 2017 December]. Available from:

2. Awad AI, Aboud EA. Knowledge, attitude and practice towards antibiotic use among the public in Kuwait. PLoS One. 2015; 10(2): e0117910. doi: 10.1371/journal.pone.0117910

3. World Health Organization [WHO]. Antimicrobial resistance: Global report on surveillance. Geneva: WHO; 2014.

4. The Review on Antimicrobial Resistance [AMR]. Antimicrobial resistance: Tackling a crisis for the health and wealth of nations. London: AMR; 2014.

5. Rather IA, Kim BC, Bajpai VK, Park YH. Self-medication and antibiotic resistance: Crisis, current challenges, and prevention. Saudi J Biol Sci. 2017 May; 24(4): 808-12. doi: 10.1016/j.sjbs.2017.01.004

6. World Health Organization [WHO]. Antimicrobial resistance. [cited 2017 December]. Available from:

7. World Health Organization [WHO]. Antimicrobial resistance: Conserving life-saving medicines takes everyone’s help. [cited 2018 January]. Available from:

8. Lv B, Zhou Z, Xu G, Yang D, Wu L, Shen Q, et al. Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China. Trop Med Int Health. 2014 Jul; 19(7): 769-79. doi: 10.1111/tmi.12322

9. Laxminarayan R, Heymann DL. Challenges of drug resistance in the developing world. BMJ. 2012 Apr; 344: e1567. doi: 10.1136/bmj.e1567

10. Borg MA, Scicluna EA. Over-the-counter acquisition of antibiotics in the Maltese general population. Int J Antimicrob Agents. 2002 Oct; 20(4): 253-7.

11. Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. Lancet Infect Dis. 2011 Sep; 11(9): 692-701. doi: 10.1016/S1473-3099(11)70054-8

12. Ocan M, Bwanga F, Bbosa GS, Bagenda D, Waako P, Ogwal-Okeng J, et al. Patterns and predictors of self-medication in northern Uganda. PLoS One. 2014; 9(3): e92323. doi: 10.1371/journal.pone.0092323

13. Davey P, Pagliari C, Hayes A. The patient's role in the spread and control of bacterial resistance to antibiotics. Clin Microbiol Infect. 2002; 8(Suppl 2): 43-68.

14. Franco BE, Altagracia Martinez M, Sanchez Rodriguez MA, Wertheimer AI. The determinants of the antibiotic resistance process. Infect Drug Resist. 2009; 2: 1-11.

15. Hulscher ME, van der Meer JW, Grol RP. Antibiotic use: how to improve it? Int J Med Microbiol. 2010 Aug; 300(6): 351-6. doi: 10.1016/j.ijmm.2010.04.003

16. Grigoryan L, Burgerhof JG, Degener JE, Deschepper R, Lundborg CS, Monnet DL, et al. Attitudes, beliefs and knowledge concerning antibiotic use and self-medication: a comparative European study. Pharmacoepidemiol Drug Saf. 2007 Nov; 16(11): 1234-43. doi: 10.1002/pds.1479

17. Basnet R, Gautam S, Subedi M. Status of over the counter buying and selling of antibiotics in Kathmandu Valley. World J Pharm Pharm Sci. 2016; 4(1): 44-53.

18. Shankar PR, Partha P, Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: a questionnaire-based study. BMC Fam Pract. 2002 Sep; 3(1): 17. doi: 10.1186/1471-2296-3-17

19. Banerjee I, Sathian B, Gupta RK, Amarendra A, Roy B, Bakthavatchalam P, et al. Self-medication practice among preclinical university students in a medical school from the city of Pokhara, Nepal. Nepal J Epidemiol. 2016 Jun; 6(2): 574-81. doi: 10.3126/nje.v6i2.15165

20. Bhattarai N, Basyal D, Bhattarai N. Self medication practice among undergraduate pharmacy students in Kathmandu Valley, Nepal. International Journal of Pharma Sciences and Research. 2014; 5(11): 737-46.

21. Sah AK, Jha RK, Shah DK. Self-medication with antibiotics among nursing students of Nepal. International Journal of Pharma Sciences and Research. 2016; 7(11): 427-30.

22. Pant N, Sagtani R, Pradhan M, Bhattarai A, Sagtani A. Self-medication with antibiotics among dental students of Kathmandu prevalence and practice. Nepal Med Coll J. 2015; 17(1-2): 47-53.

23. Government of Nepal, Central Bureau of Statistics. National population and housing census 2011. Kathmandu, Nepal; Government of Nepal; 2011.

24. Ling Oh AL, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A. Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. J Infect Dev Ctries. 2011 May; 5(5): 338-47.

25. Lim KK, Teh CC. A cross sectional study of public knowledge and attitude towards antibiotics in Putrajaya, Malaysia. South Med Rev. 2012 Dec; 5(2): 26-33.

26. Pavyde E, Veikutis V, Maciuliene A, Maciulis V, Petrikonis K, Stankevicius E. Public Knowledge, Beliefs and Behavior on Antibiotic Use and Self-Medication in Lithuania. Int J Environ Res Public Health. 2015 Jun; 12(6): 7002-16. doi: 10.3390/ijerph120607002

27. Jamhour A, El-Kheir A, Salameh P, Hanna PA, Mansour H. Antibiotic knowledge and self-medication practices in a developing country: A cross-sectional study. Am J Infect Control. 2017 Apr; 45(4): 384-8. doi: 10.1016/j.ajic.2016.11.026

28. Demore B, Mangin L, Tebano G, Pulcini C, Thilly N. Public knowledge and behaviours concerning antibiotic use and resistance in France: a cross-sectional survey. Infection. 2017 Aug; 45(4): 513-20. doi: 10.1007/s15010-017-1015-2

29. Yu M, Zhao G, Stalsby Lundborg C, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014 Feb; 14: 112. doi: 10.1186/1471-2334-14-112

30. Vallin M, Polyzoi M, Marrone G, Rosales-Klintz S, Wisell KT, Lundborg CS. Knowledge and attitudes towards antibiotic use and resistance - A latent class analysis of a Swedish population-based sample. Plos One. 2016 Apr; 11(4): e0152160. doi: 10.1371/journal.pone.0152160

31. Andre M, Vernby A, Berg J, Lundborg CS. A survey of public knowledge and awareness related to antibiotic use and resistance in Sweden. J Antimicrob Chemother. 2010 Jun; 65(6): 1292-6. doi: 10.1093/jac/dkq104

32. You JH, Yau B, Choi KC, Chau CT, Huang QR, Lee SS. Public knowledge, attitudes and behavior on antibiotic use: a telephone survey in Hong Kong. Infection. 2008 Mar; 36(2): 153-7. doi: 10.1007/s15010-007-7214-5

33. Kim SS, Moon S, Kim EJ. Public knowledge and attitudes regarding antibiotic use in South Korea. J Korean Acad Nurs. 2011 Dec; 41(6): 742-9. doi: 10.4040/jkan.2011.41.6.742

34. Mazinska B, Struzycka I, Hryniewicz W. Surveys of public knowledge and attitudes with regard to antibiotics in Poland: Did the European Antibiotic Awareness Day campaigns change attitudes? PLoS One. 2017; 12(2): e0172146. doi: 10.1371/journal.pone.0172146

35. Napolitano F, Izzo MT, Di Giuseppe G, Angelillo IF. Public knowledge, attitudes, and experience regarding the use of antibiotics in Italy. Plos One. 2013 Dec; 8(12): e84177. doi: 10.1371/journal.pone.0084177

36. Shehadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja'fari S. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharm J. 2012 Apr; 20(2): 125-33. doi: 10.1016/j.jsps.2011.11.005

37. Agarwal S, Yewale VN, Dharmapalan D. Antibiotics use and misuse in children: A knowledge, attitude and practice survey of parents in India. J Clin Diagn Res. 2015 Nov; 9(11): SC21-4. doi: 10.7860/Jcdr/2015/14933.6819

38. El Zowalaty ME, Belkina T, Bahashwan SA, El Zowalaty AE, Tebbens JD, Abdel-Salam HA, et al. Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population. Int J Clin Pharm. 2016 Oct; 38(5): 1261-8. doi: 10.1007/s11096-016-0362-x




How to Cite

Shrestha, P., Chantaraprateep, P., & Sirichokchatchawan, W. (2018). Knowledge of and attitude towards self-medication with antibiotics among general public in Kathmandu valley, Nepal: A cross-sectional survey. Journal of Health Research, 32(Suppl.1), S85-S95. Retrieved from