PILL-POPPING GONE BAD: THE ANTIBIOTIC SELF-MEDICATION

PRACTICES OF RESIDENTS OF ILOILO CITY

By Timothy John V. Concio, Alex Bernard R. Francia,
Carla Angela O. Ladrido, Evevani D. Sayson

Ateneo de Iloilo-SMCS, Atria Park District, San Rafael, Mandurriao Iloilo City

Abstract
Exactly ninety years ago, penicillin - the first antibiotic - was discovered. It took only
five generations for it to become obsolete. This is precisely what happens when drugs of
this kind are misused, underused or overused. The World Health Organization (WHO)
reported that very high rates of antibiotic resistance were observed worldwide and this is
suspected to cause common healthcare associated and community-acquired infections.

At the national level, there is little data regarding the prevalence of self-medication,
largely due to lack of priority for the collection of statistical data and analysis on the topic
whether on the side of the Department of Health (DOH) or the Food and Drug
Association. In Iloilo City, studies relating to self-medication are also very limited.

This study was therefore pursued with the aim of contributing to the medical body of
knowledge and providing data for local authorities in creating strategies and regulations
pertaining to self-medication. The researchers aimed to provide answers to the following
questions: What is the prevalence of self-medication among residents of Iloilo city? What
antibiotics do the self-medicating residents use? What factors predispose people to self-
medicate? Where do they acquire the antibiotics they use? What symptoms are they self-
medicating for?

A survey conducted with 384 respondents from 11 barangays, showed that a significant
number of residents in Iloilo City self-medicated with the use of antibiotics, especially
amoxicillin, in the past twelve months and did so in order to avoid extra costs associated
with professional medical diagnosis and prescription. This raises concerns about the
widespread inappropriate use of antibiotics among residents in Iloilo City, which could
lead to unintended consequences such as antimicrobial resistance.

Keywords:
Self-medication, Antibiotics, Antibiotic Resistance, Iloilo City

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Introduction

Penicillin, the first antibiotic, has now become obsolete. It is an antibiotic used to
treat bacterial infections especially those caused by Staphylococcus and Streptococci
(Lyon & Skurry, 1987). It became ineffective shortly after it gained extensive use in the
1940’s (Abraham, E.P., & Chain, E., 1940). Currently, on a global scale, more than 95%
of Staphylococcus aureus are resistant to penicillins (Bisht, et. al., 2009). This is precisely
what happens when drugs of this kind are misused.

An article entitled Antimicrobial resistance: Global report on surveillance 2014

published by the World Health Organization (WHO) reported that very high rates of
resistance to common bacteria were observed in all regions under their surveillance. This
is suspected to cause common health-care associated and community-acquired infections.
Soon, humans may witness the end of the antibiotics. As generations pass,
bacteria in our body grow progressively resistant to the effects of these drugs. Eventually,
industries will not be able to create antibiotic drugs capable of combating highly resistant
bacterial infections. The resistant bacteria continue to survive and multiply, leading to
more harm (Centers for Disease Control and Prevention, 2017).

Antimicrobial resistance is an umbrella term used to describe other microbes such

as viruses and parasites that have grown resistance to drugs (WHO, 2018). Another study
entitled Antimicrobial Resistance: Tackling A Crisis for the Health and Wealth of
Nations, projected the threat of antimicrobial resistance (AMR) to intensify until 2050,
which could lead to 10 million deaths annually and a reduction in the world’s gross
domestic product (GDP) by 2%-3.5% per year (O’Neill, 2014).
In the European Union alone, it was reported that the EU average percentage of
carbapenem resistance increased from 6.2% in 2012 to 8.1% in 2015 (European Centre
for Disease Prevention and Control, 2016). Carbapenems are a class of antibiotics used to
kill bacteria that have become resistant to other ordinary antibiotics. In other words, they
are the last line of defense against an otherwise antibiotic-resistant bacteria, and they are
failing.
Since 2000, the organization has been publishing articles and guidelines
promoting the prudent use of medical drugs. The guided use of antibiotics was given
particular emphasis, because the improper use of such has the potential to develop into
antibiotic resistance, a growing threat to society.

The WHO despite categorizing self-medication as a form of self-care clarified

that the misuse of medicines can create potential risks such as incorrect self-diagnosis,
inadequate or excessive dosage, and risks of abuse most especially to ordinary
individuals without specialized knowledge in pharmacology (WHO, 2000).

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 Moreover, repeated irrational use can result in immense wastage in national
health budgets, failure of treatments, and loss of credibility among health professionals
due to substandard care (The Association of Southeast Asian Nations, 2017).

Medical researchers in the past have investigated the local scene on self-
medication and produced relevant studies surrounding this practice.
Hardon’s (1987) study found that perceived severity of the illness influenced the
method of medication among a village in Luzon. Respiratory issues were considered
severe if symptoms such as runny nose and cough with either white or yellow sputum
were present. Otherwise, it was believed not to be severe.
Another study by Lansang (1991) entitled A Drugstore Survey of Antibiotic Use in
a Rural Community in the Philippines was revealed that written prescriptions were only
available to more than half of of the 6,404 antibiotic drug transactions reported. It was
observed that customers who did present written prescriptions for antibiotics only bought
75% of the number of tablets or capsules prescribed due to financial reasons.

Dy (1997) expressed in his paper entitled Inappropriate Antibiotic Use in the

Philippines that this phenomenon of rampant irrational use of antibiotics is a result of
complex interaction of multiple factors and stakeholders. This is supported by studies
developed by medical scholars that observed the cause, frequency, and predispositions
toward self-reported self-medication is highly variable across countries.

A study in Urban Puducherry, India reported self-medication to be more prevalent

in males. It was justified as males have a tendency to neglect mild illnesses (Selvaraj &
Ramalingam, 2014). But a similar study in East Indonesia revealed that females self-
medicated more than males. The researchers contest that women, as mothers, primarily
make the decisions with respect to the health of the family (Kurniawan & Rampengan,
2017). Both results run contrary to a report in Portugal that found gender differences to
have no significant effect among self-medication users (Nunes, 2006). Research on self-
medication has been inconsistent in producing a common pattern on data as to why and
how people self-medicate.

There exists, therefore, a need to conduct further testing to validate the effects of
known determinants of self-medication, and also to determine whether there are other
determinants that have not yet been identified.
At the national level, there are limited data regarding the prevalence of self-
medication, largely due to lack of priority for the collection of statistical data and analysis
on the topic whether on the side of the Department of Health (DOH) or the Food and
Drug Association.

“There are indeed drug stores that sell [antibiotics] without prescription, although
we do monitor them, but we do not put them into statistics”, disclosed by the FDA
Supervisor of Region 6. Furthermore, they also acknowledged the lack of extensive
research on the subject conducted within the City of Iloilo.

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 In Iloilo City, studies relating to self-medication are also limited. One study on
the topic was conducted in 1987 by Amatril, et al. regarding self-medication patterns
between Barangay Progreso, Lapuz and Barangay Dangulaan, Anilao. The study found
that both rural and urban communities would often self-medicate for common ailments
such as fever and cough.

Because Iloilo City currently lacks a substantial amount of up-to-date literature on

self-medication, this study aims to contribute to the medical body of knowledge and
provide data for local authorities in devising strategies and regulations pertaining to self-
medication.
This study utilizes rational choice theory as a lens in understanding the antibiotics
self-medication practices of residents in Iloilo City. This theory essentially suggests that
individuals are rational and that their choices are optimized. This means that they try to
maximize benefits from such action while minimizing the costs (Coleman & Fararo,
1992). In a gist, this research attempts to understand the decision of people to self-
medicate with antibiotics is a product of rational choice through the application of the
optimization of utility, preferences and constraints, and the discreteness and the
purposefulness of the individual. In other words, their decision to choose between using
antibiotics without prescription and using it with a doctor’s prescription (preferences) is
motivated by a desire to treat their symptoms (utility) while taking into consideration
their economic limitations (constraints).
People are discrete beings that consider several possible courses of action and
selecting one or more of these courses. When people try to achieve sub-optimal utility
because of financial constraints, ‘satisficing’ occurs. ‘Satisficing’ is a rational action
wherein an actor tries to achieve some form of benefit that can be afforded (Lovett,
2006).

Thus, this research was born out of the need to explore the prevalence of self-
medication practices of residents in Iloilo City. The researchers aimed to provide answers
to the following questions: What is the prevalence of self-medication among residents of
Iloilo city? What antibiotics do the self-medicating residents use? What are the factors
that predispose people to self-medication? Where do they acquire the antibiotics they
use? What symptoms are they self-medicating for?

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Materials and Methods

This is a descriptive, cross sectional research with the use of survey methods. It
“presents a picture of the specific details of a situation, social setting, or relationship”
(Neuman, 2007) by way of describing people’s practices, predispositions, and sources of
acquisition in their exercise of self-medication. To the extent that this study involved a
singular wave of data collection, it is therefore a cross sectional research as it enabled the
researchers to gather the necessary information from their respondents on several
occurrences (Bryman, 2008). Generally speaking, this research design also allows for
data collection in which information is gathered through interviews or through the use of
questionnaires (Sarantakos, 1993).
This research sought to conduct the investigation within the city of Iloilo from
December 2017 to January 2018, through a survey method with the use of questionnaires.
According to Neuman (2007), survey research allows the researchers to develop an
instrument - a survey questionnaire - that can measure the variables included in the study.
Probing personal interviews were also conducted in order to substantiate responses in the
survey questionnaire.

The instrument was subjected to content validation, pilot testing, and reliability
testing. A panel of experts was constituted consisting of Hiligaynon and English linguists,
a research methods expert, a pharmacist, a licensed physician, and a statistician. The
instrument was revised based on the recommendations of the members of the said panel
and was subjected to a pilot testing in Oton, Iloilo last December 16, 2018. After the
responses were collected, the data were subjected to reliability testing. The internal
consistency of the instrument was measured using Cronbach’s alpha, which is a measure
of internal consistency whereby the closeness of each item to one another is determined
(Triola, 2012). The test revealed that the Cronbach’s alpha of the instrument was 7.9
which signifies that it was was highly reliable. The actual administration of survey was
ensued immediately after the reliability of the instrument was established.

The study employed a multi-stage sampling method. In the first stage, sample
barangays were chosen from the 180 total barangays in Iloilo City. In the second stage,
households were randomly sampled from each chosen barangay. Finally, in the third
stage, a simple random sampling of individuals was used in order to identify specific
respondents from each household.
The sample size was computed using the following Cochran’s sample size
determination formula:

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 A total of three hundred and eighty four (384) respondents were sampled from
different barangays in Iloilo City. A total of eleven barangays representing each district
were included in the survey. The distribution of samples is reflected in the table below.

Table 1. Distribution of Samples

District Barangay Population Sample Size

Size (N) (n)
Arevalo Calaparan 8,699 49
City Proper I Hipodromo 856 21
City Proper II Villa Anita 1,293 23
Lapaz I Jereos 3,839 22
Lapaz II Baldoza 6,739 24
Lapuz Obrero-Lapuz 6,419 26
Mandurriao Bolilao 6,519 50
Molo I North 2,439 20
Fundidor
Molo II Calumpang 15,150 45
Jaro I Benedicto 2,979 46
Jaro II Balabago 8,594 58
TOTAL 63,526 384

Respondents were given Informed Consent Forms explaining to them the nature
and intent of the survey. Each of them signed a conforme stating that they agreed to
participate in the study and that data gathered from them were going to be used for
academic purposes only. If a respondent is below 18 years of age, they were instructed to
ask for consent from an available parent or guardian.

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Results and Discussions

This study looked into the prevalence of antibiotics self-medication among

residents in Iloilo City and sought to identify key factors that prompted this practice. Also
included in the study were the types of antibiotic used, sources of acquisition of the
antibiotics, and the symptoms for which they were used.

Socio-Economic and Demographic Profile

The socio-economic and demographic profile of the respondents were tabulated
and tested for possible relationships with self-medication. Commented [1]: really not sure what im saying lul

Table 2. Socio-economic and Demographic Profile of Respondents

Frequency (n=384) Percentage (%)
Age
15-17 1 0.26%
18-24 45 11.72%
25-34 79 20.57%
35-44 87 22.66%
45-54 68 17.71%
55-64 56 14.58%
65-74 37 9.64%
75-above 11 2.86%
Occupation
Housewife 64 16.67%
Laborer 71 18.49%
Retired 25 6.51%
Students 18 4.69%
Unemployed 79 20.57%
Driver 32 8.33%
Businessman 27 7.03%
Government Official
or Officer 17 4.43%
Others 51 13.28%
Sex
Male 137 35.68%
Female 247 64.32%
Civil Status
Single 122 31.77%
Married 220 57.29%
Widow/Widower 34 8.85%
Separated 8 2.08%

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 Highest Educational Attainment
Never went to school 1 0.26%
Some elementary 4 1.04%
Elementary graduate 30 7.81%
Some high school 45 11.72%
High school graduate 123 32.03%
Some college 52 13.54%
College graduate 125 32.55%
Finished graduate
school 4 1.04%
Monthly Income
0-2000 124 32.29%
2001-5000 66 17.19%
5001-10000 97 25.26%
10001-above 97 25.26%
Head of Household
Yes 174 45.31%
No 210 54.69%
Number of people in household
Mode 4

Table 2 exhibits the tabulated values and corresponding percentage values socio-
economic and demographic factors of respondents.

Age ranges included people aged 15-75, in which the mean age was 44 years old.
Laborers were presented to represent a large portion of among the 384 respondents
(18.49%). Among the 384 respondents, 137 were male and 247 were female. Civil Status
was classified into 4 groups, with Married as the most common (57.29%). Furthermore,
32.29% estimated their income to be 0- 2000 Php per month. A majority of the
respondents ranged from high school graduates to college graduates. There seemed to be
an equal distribution of respondents who claimed to be head of their household. 45.31%
agreed to be the head of household while 54.69% said otherwise. There was an average
of 4 persons per household among respondents.

Prevalence of Antibiotics Self-Medication in Iloilo City

The views and attitudes toward antibiotic self-medication of the residents among
the eleven barangays of Iloilo City were tabulated with the use of counts and percentages.

Table 3. Use of Antibiotics without Prescription in the Past Twelve Months

Frequency Percentage
Used Antibiotics without Doctor’s Prescription
(n=384) (%)
No 232 60.42%
Yes 152 39.58%

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 Table 3 presents the respondents’ use and consumption of antibiotics. Based on a
survey of 384 respondents from eleven barangays in Iloilo City, it was found that 232 or
60.42% did not use antibiotics without a doctor’s prescription in the last twelve months,
while 152 or 39.58% had self-medicated with antibiotics in the same period.

Table 4. Frequency of Use of Antibiotics without Doctor’s Prescription

Percentage
Frequency Percentage (%) of Self-
No. of Times Used Medicating
(n=384) (%)
People (152)
Once 28 7.29% 18.42%
2-3 Times 65 16.93% 42.76%
4-5 Times 18 4.69% 11.84%
More than 6 Times 41 10.68% 26.97%

In Table 4, it can be observed that among those who self-medicated with

antibiotics, 65 or 42.76% reported to have self-medicated with antibiotics for two to three
times, and 41 or 26.97% admitted to using antibiotics without a doctor’s prescription for
more than six times in the past year.

Table 5. Types of Antibiotics used by People who Self-Medicated

Percentage
Frequency Percentage (%) of Self-
Type of Antibiotics Used Medicating
(n=384) (%)
People (152)
Can’t remember 0 0.00% 0.00%
Don’t know 2 0.52% 1.32%
Amoxicillin 147 38.28% 96.71%
Amoxicillin + Clavulanic Acid 6 1.56% 3.95%
Azithromycin 1 0.26% 0.66%
Cefaclor 2 0.52% 1.32%
Cefalexin 44 11.46% 28.95%
Cefuroxime 4 1.04% 2.63%
Ciprofloxacin 3 0.78% 1.97%
Clarithromycin 1 0.26% 0.66%
Clindamycin 1 0.26% 0.66%
Cotramoxizole / Trimethoprim +
5 1.30% 3.29%
Sulfamethoxazole
Erythromycin 6 1.56% 3.95%
Gentamycin 1 0.26% 0.66%
Metronidazole 3 0.78% 1.97%
Moxifloxacin 0 0.00% 0.00%
Mupirocin 0 0.00% 0.00%
Ofloxacin 1 0.26% 0.66%
TB Antibiotics 0 0.00% 0.00%
others (penicillin) 1 0.26% 0.66%

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 Table 5 indicates that Amoxicillin and Cephalexin were found to be the most
frequently used in self-medication. Amoxicillin was found to have been used by 147 or
96.71% of the self-medicating respondents, while 44 or 28.95% of them had used
Cefalexin. A number of people admitted that they have become accustomed to using
amoxicillin because it was prescribed to them by a dentist in the past in order to prevent
infection from tooth extraction or other previous dental procedures.
During interviews, several respondents directly associated symptoms such as
toothache to the use of amoxicillin. This implies that antibiotics are being constantly
being reused for self-medication. This may be due to a cultural belief that certain
antibiotics are always the go-to drugs for certain symptoms. One respondent asserted that
as soon as the pain has subsided, it is acceptable to cease the full dosage. Dosage
compliance was thus discovered as a major issue among self-medicating respondents.
Another example of such is when amoxicillin has proved successful in treating a
symptom such as cough, the user would tend to take amoxicillin whenever the same
symptom would occur, thereby increasing that person’s chance of developing resistance
to amoxicillin, while simultaneously decreasing that person's tendency to seek medical
attention.

Relationship between Socio-Demographic Profile and Self Medication

Table 6 presents the values of Pearson Chi-Square, Asymptotic Significance, Phi
Value, and Cramer’s Value for the socio-demographic factors. The following table
presents the relationships found between these factors based on the results of the
statistical tools.

Table 6. Correlation between Socio-Demographic Profile and Self-Medication

Pearson Asymptotic Cramer’s

Phi Value
Chi-Square Significance Value

Occupation 110.04 0.375 0.535 0.535

Sex 0.675 0.411 0.042 0.042

Civil Status 3.246 0.355 0.092 0.092

Highest Educational
13.727 0.56 0.189 0.1859
Attainment

Average Monthly Income 10.138 0.017 0.162 0.162

Head of Household 2.077 0.91 0.074 0.074

Among the factors presented, only Average Monthly Income was found to have a
significant positive relationship with the practice of self-medication. This relationship,
however, is a weak relationship, and as such, has a relatively minimal effect on self-
medication.

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 It can be concluded that antibiotic self-medication practices of the residents of
Iloilo City are not affected by occupation, sex, civil status, highest educational
attainment, and whether or not an individual is the head of household.

Factors that Predispose People toward Antibiotic Self-Medication

Tables 7a to 7d show the different factors that predispose people towards self-
medication with antibiotics.
It was found that among the sampled population of residents in Iloilo City, 95 or
62.50% of the self-medicating population chose to self-medicate with antibiotics in order
to avoid paying extra for doctor’s consultation fees. Under costs, the second highest
reason for choosing to self-medicate was to avoid the cost of expensive branded
medicine, which comprised of 49 or 32.24% of the self-medicating population.

Table 7a. Cost as Factor for People’s Self-Medication with Antibiotics

Percentage
Frequency Percentage (%) of Self-
Cost Medicating
(n=384) (%)
People (152)
avoid paying extra for doctor’s
95 24.74% 62.50%
consultation fees
save on transportation in going to
28 7.29% 18.42%
the doctor’s clinic
avoid the cost of expensive branded
49 12.76% 32.24%
medicine
avoid additional laboratory fees 16 4.17% 10.53%
avoid the possibility of hospital
39 10.16% 25.66%
expenses
avoid waiting for the doctor 42 10.94% 27.63%
others 1 0.26% 0.66%
Table 7b. Fear as Factor for People’s Self-Medication with Antibiotics
Percentage
Frequency Percentage (%) of Self-
Fear Medicating
(n=384) (%)
People (152)
afraid of doctors 1 0.26% 0.66%
do not trust doctors 5 1.30% 3.29%
afraid of the possible procedures to
4 1.04% 2.63%
be done in the hospital
afraid of knowing more about my
8 2.08% 5.26%
health condition
others 0 0.00% 0.00%

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 Table 7c. External Factors for People’s Self-Medication with Antibiotics
Percentage
Frequency Percentage (%) of Self-
External Influence Medicating
(n=384) (%)
People (152)
family 51 13.28% 33.55%
friends 28 7.29% 18.42%
neighbors 16 4.17% 10.53%
workmates 4 1.04% 2.63%
others 2 0.52% 1.32%

Table 7d. Personal Factors for People’s Self-Medication with Antibiotics

Percentage
Frequency Percentage (%) of Self-
Personal Experience Medicating
(n=384) (%)
People (152)
used internet to diagnose and
6 1.56% 3.95%
medicate
prior symptoms and use of
90 23.44% 59.21%
antibiotics
got used to it 32 8.33% 21.05%
condition was not serious 13 3.39% 8.55%
others 11 2.86% 7.24%

External influence also played a role in influencing people to self-medicate.

Among all the reasons, family was the top influence in people’s decision to self-medicate
with antibiotics, which is 33.55% or 51 respondents among those who self-medicated.

Among the reasons listed under personal experience, 90 or 59.21% of the self-
medicating respondents reported to have had experienced similar symptoms before and
had used the same antibiotics prescribed to them in the past. Also, 32 or 21.05% said that
they chose to self-medicate because they got used to using antibiotics regularly.

During the interviews with the respondents, many have reasoned out that the
practice of self-medication was naandan, or was learned from the behavior of family
members when presented with a similar illness. For many, this practice has become a
norm adopted and shared from generation to generation.

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Sources of Acquisition of Antibiotics
Table 8. Sources where Antibiotics were Acquired
Percentage
Frequency Percentage (%) of Self-
Sources Medicating
(n=384) (%)
People (152)
Drugstores/Pharmacies 68 17.71% 44.74%
Community Health Centers 2 0.52% 1.32%
Barangay Health Center 28 7.29% 18.42%
Friends, Family, Co-workers 4 1.04% 2.63%
Leftover Medication 4 1.04% 2.63%
Sari-Sari Stores 73 19.01% 48.03%
others 12 3.13% 7.89%

Out of the 152 respondents who professed to have self-medicated, 73 or 48.03%

acquired their antibiotics without the need for a doctor’s prescription from sari-sari stores,
68 or 44.74% from drugstores, and 28 or 18.42% obtained from the Barangay Health
Center.
It was discovered that sari-sari stores were the most common sources where the
users acquired their antibiotics for self-medication. These small businesses did not
require any prescription when selling these drugs. One store owner proclaimed that the
selling of antibiotics without a licensed pharmacist nor a prescription is justified as long
as the self-medicating buyer is initially educated by the storeowner about the drug.

Another surprising finding was that medical representatives roamed around the
area to sell drugs, including antibiotics to them. This is an alarming discovery as medical
representatives are prohibited from selling and administering drugs such as antibiotics to
unlicensed businesses outside of the healthcare industry. The researchers found a box of
Cotrimoxazole displayed publicly for sale inside a vulcanizing shop in one of the
barangays.

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Symptoms for which People Self-Medicated
When asked about the symptoms or illnesses respondents were self-medicating for,
64 or 42.11% of them confirmed that it was for toothache. The actual results are presented
below.
Table 9. Symptoms that People Self-Medicated for
Percentage
Frequency Percentage (%) of Self-
Symptoms Medicating
(n=384) (%)
People (152)
Abdominal Pain 6 1.56% 3.95%
Cough 47 12.24% 30.92%
Fever 25 6.51% 16.45%
Headache 23 5.99% 15.13%
Nasal Congestion 5 1.30% 3.29%
Sore Eyes 3 0.78% 1.97%
Sore Throat 16 4.17% 10.53%
Wound 54 14.06% 35.53%
Toothache 64 16.67% 42.11%
others 27 7.03% 17.76%

Moreover, a significant number of the respondents reported wounds and cough as

among the conditions that they treated with antibiotics without prescription. Specifically,
54 or 35.53% said they used antibiotics to treat their wounds, and 25 or 16.45% of them
self-medicated with antibiotics to treat cough.

Conclusions

This study found that a significant portion of residents in Iloilo City self-
medicated with the use of antibiotics in the last twelve months. Two in every five
residents in Iloilo City purchased and consumed antibiotics without the guidance of a
licensed doctor/pharmacist. Furthermore, two in every five of these self-medicating
people did so for about two to three times in the past year. A vast majority of them were
found to have self-medicated with the use of Amoxicillin as a specific type of antibiotic.
Furthermore, certain factors were found to have predisposed these people to self-
medicate. 62.50% of them used antibiotics without prescription in order to avoid paying
extra for doctor’s consultation fees, while 32.24% of them wanted to avoid the cost of
expensive branded medicine. Around 33.55% of these individuals admitted to being
influenced by family members to use antibiotics without a doctor’s prescription. It was
also found that 59.21% of them self-medicated with antibiotics because of an experience
with the use of antibiotics to treat prior similar symptoms.

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 Interestingly, 48.03% of self-medicating residents admitted that they acquired
their antibiotics from sari-sari stores, while 44.74% of them said they got it from
legitimate drug stores or pharmacies.

Finally, this study revealed that self-medicating residents of Iloilo City used
antibiotics in order to treat certain symptoms. About 42.11% of them used antibiotics in
order to treat toothache, while 35.53% used it for wounds, and 30.92% of them used
antibiotics for cough treatment.
The results show that a significant number of self-medicating residents used
antibiotics without prescription in order to avoid paying more for consultation fees and
avoid paying for expensive branded medicine that a doctor may potentially prescribe. The
inclination to self-medicate also appears to be greatly motivated by the influence of
family members and prior experience with the use of antibiotics in treating similar
symptom. These behaviors and choices reflect cost-avoidance, which is consistent with
the idea that self-medication is a rational action.
Bypassing professional medical consultation and relying instead on
recommendations from family members and antecedent experience with antibiotics as
basis for informing their decision to self-medicate may be construed as a ‘satisficing’
behavior. By self-medicating, people are still able to achieve their expected utility, albeit
only sub-optimally, without expending a lot of financial resources in the process. The
perfect scenario is that an individual achieves perfect utility by receiving treatment for a
symptom or illness. However, this is attained at a high cost - doctor’s fees, cost of
medicine, etc. Self-medicating individuals use antibiotics without prescription in order to
achieve treatment while saving money. It must be realized, however, that this
‘satisficing’ behavior comes at a great risk. In the absence of proper diagnosis and
prescription from a licensed physician, a self-medicating individual could end up treating
a wrong medical condition, or underusing or overusing a drug. This practice could
potentially contribute to the growing global trend of antibiotic resistance. This raises
concerns about the widespread inappropriate use of antibiotics among residents in Iloilo
City which could lead to unintended consequences such as antimicrobial resistance.
Stricter implementation of the laws and regulations surrounding the distribution of
antibiotics among business establishments should be imposed, most especially legal
stipulations that prohibit the sale of prescription antibiotics and other prescription drugs
in sari-sari stores and other establishments that are not licensed and have no professional
medical supervision. Likewise, strict sanctions should be imposed among those who
distribute prescription antibiotics illegally. The government should strengthen its
campaign against antimicrobial resistance and raise awareness regarding proper usage of
antibiotics with particular focus on the adverse effects of antibiotic self-medication.

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References

Abraham E.P., and Chain, E. (1940). An enzyme from bacteria able to destroy bacteria.
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