Prevalence and predictors of self-medication with antibiotics among adults in Santo Domingo and the National District, Dominican Republic: an online cross-sectional study

BACKGROUND: Antibiotic self-medication significantly contributes to increasing antimicrobial resistance, a critical public health challenge that is particularly affecting low- and middle-income countries. While antibiotic stewardship initiatives primarily target healthcare facilities, community-level antibiotic usage and pharmacy dispensing practices often lack adequate regulation. This study aimed to assess the prevalence of and identify sociodemographic factors associated with antibiotic self-medication among adults in Santo Domingo and the National District of the Dominican Republic. METHODS: A cross-sectional study employing a convenience sampling approach was conducted in October 2024. Data were collected via a self-administered online questionnaire distributed to participants residing in Santo Domingo and the National District. Descriptive statistics, chi-square tests, and multinomial logistic regression analyses were applied to investigate the associations between sociodemographic variables and antibiotic self-medication behaviors. RESULTS: Of the 687 participants surveyed, 14.6% (n = 100) reported engaging in antibiotic self-medication within the preceding 12 months. Amoxicillin was the most frequently self-administered antibiotic (69%), primarily obtained from pharmacies (98%). The principal motivation for self-medication was convenience (56%). The most common symptoms prompting antibiotic use were sore throat (55%) and nasal congestion (23%). Multinomial logistic regression revealed that, compared to participants who did not use antibiotics, those in the low-middle-income (OR: 4.30; p < 0.001) and middle-income (OR: 2.59; p = 0.026) groups had significantly higher odds of self-medicating. Furthermore, compared to participants who obtained antibiotics via a doctor’s prescription, those in the low-middle-income group also had increased odds of self-medication (OR: 2.39; p = 0.042). CONCLUSIONS: These findings underscore the necessity for targeted interventions to mitigate antibiotic misuse. Public awareness campaigns, particularly within pharmacies and community centers, should emphasize the inherent risks associated with self-medication. Enforcing prescription-only regulations for antibiotic sales within the Dominican Republic is imperative to curtail unregulated access and foster responsible antibiotic consumption practices.