Self-Medication of Antibiotics

Research Report on Self-Medication of Antibiotics in M.P.
State, India
CHRIST UNIVERSITY INSTITUTE OF MANAGEMENT

BANGALORE
A STUDY ON PREVALENCE OF THE Practise OF

Self-medication of ANTIBIOTICS IN
M.P. State, INDIA
SUBMITTED TO:
PROF. VENKATESHA BHAGAVATH
CUIM, BANGALORE
SUBMITTED BY:
KINSHOO SHAH
1st yr, MBA (IB), CUIM
1
Research Report on Self-Medication of Antibiotics in M.P. State, India
CERTIFICATE OF THE GUIDE
This is to certify that the Project Work titled “A STUDY ON PREVALENCE OF THE
PRACTISE OF SELF-MEDICATION OF ANTIBIOTICS IN M.P. STATE, INDIA” is a
bonafide work of the researcher KINSHOO SHAH carried out in partial fulfillment for the award
of degree of MBA in International Business from Christ University Institute of
Management under my guidance. This project work is original and not submitted earlier for the
award of any degree diploma or associate ship of any other University / Institution.
Name of Guide in charge, Signature of the Guide in charge,

Prof. Venkatesh Bhagavath
Place: Bangalore
Date: 27th April 2010
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ACKNOWLEDGEMENT
We owe thanks to a great many people who helped and supported us during the course of this
project work.
We express our deepest gratitude to our lecturer, Prof. Venkatesh Bhagavath the Guide of the
project for guiding and correcting various documents of ours with attention and care. He has
taken pain to go through the project and make necessary correction as and when needed. He has
been a constant source of encouragement, guidance and support from the initial to the final level
enabled us to develop an understanding of the subject.
We are over helmed in all humbleness and gratefulness to acknowledge our depth to all those
who have helped us to put these ideas, well above the level of simplicity and into something
concrete.
We would also thank our institution and my faculty members without whom this project would
be a distant reality.
Our deep sense of gratitude to the people, pharmacists/chemists/druggists and doctors for the
support and guidance.
3
ABSTRACT
The project was undertaken as a part of our MBA in IB course curriculum at Christ University
Institute of Management.
The recent trends reveal a surprising fact that the tendency of self-medication if growing in
people with the advent of internet and more detailed health books, ignoring the bitter truth that
self-medication can be dangerous.
It is very unfortunate to see people blindly consuming Antibiotic without even realising what
harm they can do to their body. There are people who are addicted to antibiotics, for every silly
disease they advice to take antibiotics without consulting doctor.
From sore throat to body pain, people use antibiotics. Fever, cold, cough, constipation or
indigestion is among the usual cases of self-medication. The mostly misused drugs are analgesics
or pain relievers. For some it works, but for others it’s not always good news.
It is also seen that usually for some common ailments like fever & indigestion; people often
don’t prefer to consult a physician. Instead they either utilize their own knowledge through
reading of health books, articles or internet; or refer a pharmacist/chemist/druggist and ask them
to give some medicines, who often think of themselves as half doctor.
However, the important questions are”
“Is the practise of self-medication still prevalent in India?”
“Is this practice fair on the pharmacists’/chemists’/druggists’ part to dispense Antibiotics

without doctor’s prescription?”
“How far is it justified to take risk with the health of the patients?”
Through this research project we analyzed the various facets involved to study the results of
dispensing Antibiotics over the counter in India and how far is this practice justified concerning
patients life. For this we conducted the study based on a few pharmacist/chemist shops, doctors
and some people in the vicinity.
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STATEMENT OF AUTHENTICITY
We hereby declare that the project work entitled “A STUDY ON PREVALENCE OF THE
PRACTISE OF SELF-MEDICATION OF ANTIBIOTICS IN M.P. STATE, INDIA”
submitted to the Christ University Institute Of Management, is a record of an original work
done by us under the guidance of Prof. Venkatesh Bhagavath, Faculty Member and this project
work has not performed the basis for the award of any Degree or diploma/ associate
ship/fellowship and similar project if any.
Research Person:
KINSHOO SHAH, 1st yr, MBA (IB), CUIM
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CONTENTS
CHAPTER 1: INTRODUCTION.............................................................................................10
Health Definitions...................................................................................................................... 10
Over The Counter Drugs....................................................................................................................11
Chemist & Pharmacist- Roles & Responsibilities……………………………………...….......11
About Antibiotics- Side Effects& Allergy................................................................................................13
Self-Medication...................................................................................................................................16
Factors That Influence The Tendency of Self-Medication.............................................................16
Problem Statement..............................................................................................................................17
Research Objectives............................................................................................................................17
CHAPTER 2: LITERATURE REVIEW..................................................................................19
Studies Exploring Antibiotic Misuse................................................................................................19
Antibiotics Use Linked to Ashtma....................................................................................................19
Socioeconomis & Behavioral Factors................................................................................................20
Antibiotics as Cause of Resistance....................................................................................................20
Self-Medication with Antibiotics......................................................................................................21
Self-Medication in India.....................................................................................................................23
Social Factors Leading to Self-Medication in India........................................................................25
Statistics...............................................................................................................................................27
CHAPTER 3: STUDY DESIGN & METHODOLOGY....................................................................28
Data Collection Method.....................................................................................................................28
Data Sources........................................................................................................................................28
Research Instruments.........................................................................................................................28
Sampling Design.................................................................................................................................28
Period Covered By The Study...........................................................................................................29
Sampling Unit.....................................................................................................................................29
Sample Size..........................................................................................................................................29
Survey Method....................................................................................................................................29
Experiment Method............................................................................................................................30
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Action Plan Followed.........................................................................................................................31

CHAPTER 4: PRESENTATION & ANALYSIS OF DATA.............................................................32
Software Used.....................................................................................................................................32
Main Hypothesis:................................................................................................................................33
Data Characteristics............................................................................................................................33
Percentage of Antibiotic USers..........................................................................................................34
Hypothesis 1........................................................................................................................................34
Frequency of Usage of Antibiotics....................................................................................................35
Hypothesis 2........................................................................................................................................35
Patient Awareness - Further Analysis..............................................................................................36
Hypothesis 3........................................................................................................................................36
Hypothesis4.........................................................................................................................................40
Education as a Factor of Self-Medication.........................................................................................42
Hypothesis 5........................................................................................................................................42
Ailments Commonly Subjected to Self-Medication........................................................................43
Pharmacist/Chemists Responsiveness............................................................................................45
Hypothesis 6........................................................................................................................................45
Hypothesis 7........................................................................................................................................48
Doctor’s Point of View.......................................................................................................................51
Hypothesis 8........................................................................................................................................51
CHAPTER: 5 DISCUSSION & INTERPRETATION OF FINDINGS..........................................53
Main Hypothesis:................................................................................................................................53
Hypothesis 1........................................................................................................................................53
Hypothesis 2........................................................................................................................................53
Hypothesis 3........................................................................................................................................54
Hypothesis 4........................................................................................................................................55
Hypothesis 5........................................................................................................................................56
Hypothesis 6........................................................................................................................................56
Hypothesis 7........................................................................................................................................57
Hypothesis 8........................................................................................................................................57
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CHAPTER: 6 CONCLUSION, IMPLICATION & RECOMMENDATION.................................59

Benefits Of This Research..................................................................................................................59
Limitations:..........................................................................................................................................60
Recommendation:...............................................................................................................................60
Conclusion:..........................................................................................................................................61
REFERENCES.........................................................................................................................................62
Websites & Sources.............................................................................................................................62
Bibliography........................................................................................................................................62
LIST OF TABLES AND FIGURES
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S. No List of Tables Page No. S. No List of Tables Page No.
1.1 Table 1 23 1.11 Table 11 45
1.2 Table 2 24 1.12 Table 12 45
1.3 Table 3 37 1.13 Table 13 46
1.4 Table 4 37 1.14 Table 14 47
1.5 Table 5 38 1.15 Table 15 48
1.6 Table 6 38 1.16 Table 16 49
1.7 Table 7 39 1.17 Table 17 50
1.8 Table 8 40 1.18 Table 18 51
1.9 Table 9 42 1.19 Table 19 52
1.10 Table 10 43
S. No List of Pie Charts Page

S. No List of Figures Page No.
No.
5.1 Pie-Chart: 1 34
2.1 Figure 1 32
5.2 Pie-Chart: 2 34
2.2 Figure 2 33
5.3 Pie-Chart: 3 35
3.1 Flowchart 1 31
5.4 Pie-Chart: 4 35
4.1 Bar-Chart: 1 37
5.5 Pie-Chart: 5 36
4.2 Bar-Chart: 2 41
5.6 Pie-Chart: 6 44
4.3 Bar-Chart: 3 46
5.7 Pie-Chart: 7 44
4.4 Bar-Chart: 4 47
5.8 Pie-Chart: 8 49
4.5 Bar-Chart: 5 48
5.9 Pie-Chart: 9 50
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CHAPTER 1: INTRODUCTION
“Mens sana in corpore sano”

~ Juvenal
(Your prayer must be for a sound mind in a sound body.)
HEALTH is the general condition of a person in all aspects. It is also a level of functional and/or
metabolic efficiency of an organism, often implicitly human.
At the time of the creation of the World Health Organization (WHO), in 1948, health was
defined as being "a state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity". [Ref 1]
Achieving and maintaining health is an ongoing process. Effective strategies for staying healthy
and improving one's health include the following elements:
 Observation of daily living.
 Social Activity.
 Hygiene.
 Stress Management.
 Health Care.
Overall health is achieved through a combination of physical, mental, emotional, and social well-
being, which, together is commonly referred to as the Health Triangle.
The LaLonde report suggests that there are four general determinants of health including
 human biology,
 environment,
 lifestyle and
 Healthcare services.
Thus, health is maintained and improved not only through the advancement and application
of health science, but also through the efforts and intelligent lifestyle choices of the individual
and society.
A major environmental factor is water quality, especially for the health of infants and children
in developing countries.
A common saying about health:
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“Health is not valued till sickness comes”.

~ Dr. Thomas Fuller
OVER-THE-COUNTER (OTC) DRUGS are medicines that may be sold directly to a

consumer without a prescription from a health care professional, as compared to prescription
drugs, which may only be sold to consumers possessing a valid prescription. [Ref 2]
In many countries, OTC drugs are selected by a regulatory agency to ensure that they are
ingredients that are safe and effective when used without a physician's care.
OTC drugs enable people to relieve many annoying symptoms and to cure some diseases simply
and without the cost of seeing a doctor. However, safe use of these drugs requires knowledge,
common sense, and responsibility.
In addition to the substances such as aspirin and acetaminophen that people typically think of as

OTC drugs, many other commonly available products are considered OTC drugs by the federal
Food and Drug Administration (FDA). Some toothpastes, some mouthwashes, some types of eye
drops, wart removers, first aid creams and ointments that contain antibiotics, and even dandruff
shampoos are considered OTC drugs.
Some OTC drugs were originally available only by prescription. After many years of use under
prescription regulation, drugs with excellent safety records may be approved by the FDA for
over-the-counter sale. The analgesic ibuprofen and the indigestion remedy famotidine are
examples of such drugs. Often, the OTC version has a substantially lower amount of active
ingredient in each tablet, capsule, or caplet than does the prescription drug. When establishing
appropriate doses of OTC drugs, manufacturers and the FDA try to balance safety and
effectiveness.
Safety Considerations
Safety is a major concern when the FDA considers reclassifying a prescription drug as OTC.
Most OTC drugs—unlike health foods, dietary supplements (including medicinal herbs) and
complementary therapies —have been studied scientifically and extensively. However, all drugs
have benefits and risks, and some degree of risk has to be tolerated if people are to receive a
drug's benefits.
Safety depends on using a drug properly. For OTC drugs, proper use often relies on consumer
self-diagnosis, which leaves room for error. For example, most headaches are not dangerous, but
in rare cases, a headache is an early warning of a brain tumor or hemorrhage.
People who purchase OTC drugs should read and follow the instructions carefully. Because
different formulations—such as immediate-release and controlled-release (slow-release)
formulations—may have the same brand name, the label should be checked each time a product
is purchased, and the dosage should be noted.
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Often, the labels of OTC drugs do not list the full range of possible side effects. As a result,
many people assume that these drugs have few, if any, side effects. For example, the package
insert for one analgesic cautions people not to take the drug for more than 10 days for pain.
However, the possible serious side effects that can occur with long-term use (such as life-
threatening bleeding from the digestive tract) are not mentioned—not on the box, bottle, or
package insert. Consequently, people with chronic pain or inflammation may take the drug for a
long time without realizing that such use could lead to serious problems.
Considerations in Reclassifying a Drug as Over-The-Counter: [Ref 3]
Safety
 Has the drug been used for a long enough time so that any harmful effects are fully
understood?
 What harmful effects (including those form misuse) may the drug produce?
 Is the drug habit forming?
 Do the benefits of OTC status outweigh the risks?
Ease of Diagnosis & Treatment
 Can the average person self-diagnose the condition that calls for the drugs?
 Can the average person treat the condition without help of a doctor or other health care
practitioner?
Labelling
 Can adequate directions for use be written?
 Can warnings against unsafe use be written?
 Can the average person understand the information on the label?
CHEMISTS & PHARMACISTS
Pharmacists are health professionals who practice the science of pharmacy. In their traditional

role, pharmacists typically take a request for medicines from a prescribing health care provider in
the form of a medical prescription, evaluate the appropriateness of the prescription, dispense the
medication to the patient and counsel them on the proper use and adverse effects of that
medication. [Ref 4]
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At present there are around 14 lakhs chemists/pharmacists in India and in the coming years the
industry is expected to generate an annual turnover of more than $11 billion in India. The major
players in Indian pharmacy retail sector are Reliance (R-ADAG), Hong Kong-based Zuellig
Pharma, US-based Cardinal Health, Apollo Health, Fortis Healthworld, Subiksha, Manipal Cure
& Care and Medicine shoppe.
Roles & Responsibilities:
 Pharmacists/druggists/chemists act as a learned intermediary between physicians and

patients and thus ensure the safe and effective use of medications.
 Pharmacists/druggists/chemists also participate in disease-state management, where they

optimize and monitor drug therapy or interpret medical laboratory results – in
collaboration with physicians and/or other health professionals.
One of the most important roles that pharmacists are currently taking on is one of
pharmaceutical care. Pharmaceutical care involves taking direct responsibility for patients and
their disease states, medications, and the management of each in order to improve the outcome
for each individual patient. Pharmaceutical care has many benefits that include but are not
limited to:
 Decreased medication errors

 Increased patient compliance in medication regimen
 Better chronic disease state management
 Strong pharmacist-patient relationship
 Decreased long-term costs of medical care
About ANTIBIOTICS
An Antibiotic is substance or compound that kills or inhibits the growth of bacteria. Antibiotics
belong to the broader group of antimicrobial compounds, used to treat infections caused
by microorganisms, including fungi and protozoa. [Ref 5]
Oral antibiotics are simply ingested, while intravenous antibiotics are used in more serious cases,
such as deep-seated systemic infections. Antibiotics may also sometimes be
administered topically, as with eye drops or ointments.
Few antibiotics: Penicillin, Cephalosporins, Macrolides, Quinolones, Carbapenems, and Other

Antibiotics (Aminoglycosides, Tetracyclines, Sulfonamides, Mupirocin, Glycopeptides,
Synercid, and Oxazolidinones.
Few manufactures of Antibiotics: Abbott Laboratories, Advancis Pharmaceutical Corp., Bayer

HealthCare AG, Bristol-Myers Squibb Co., Cubist Pharmaceuticals, Inc., Daiichi Sankyo
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Company, Limited, Eli Lilly and Co., GlaxoSmithKline Plc, Johnson & Johnson, Kyorin
Pharmaceutical Co., Ltd., LG Life Sciences Limited, Novartis AG, Pfizer Inc., Pliva d.d.,
Ranbaxy Laboratories Ltd, Roche, Sanofi-Aventis SA, Takeda Pharmaceutical Company, Ltd.,
Toyama Chemical Co., Ltd., and Wyeth Pharmaceuticals, Inc.
Side effects
Although antibiotics are generally considered safe and well tolerated, they have been associated
with a wide range of adverse effects. Side effects are many, varied and can be very serious
depending on the antibiotics used and the microbial organisms targeted. The safety profiles of
newer medications may not be as well established as those that have been in use for many years.
“The first rule of antibiotics is try not to use them, and the second rule is try not to use too many
of them”.
~ Paul L. Marino, The ICU
Book
Adverse effects may include:

 Fever
 Nausea
 Photo dermatitis
 Anaphylaxis
 Diarrhoea &/or Dehydration
 Abdominal Pain
 Prolonged or incorrect use of antibiotics can cause an individual to become weak and
more susceptible to outside infections.
 Colitis, the inflammation of the colon is a rare effect.
 More serious side effects include the formation of kidney stones with the sulphonamides,
abnormal blood clotting with some of the cephalosporin, increased sensitivity to the sun
with the tetracycline, blood disorders with trimethoprim, and deafness with erythromycin
and the amino glycoside.
 In case of overdose, there is a chance of increasing the risk of cancer.
 Other side effects can result from interaction with other drugs (called drug-drug
interaction), such as elevated risk of tendon damage from administration of
a quinolone antibiotic with a systemic corticosteroid.
 Inappropriate antibiotic treatment and overuse of antibiotics have been a contributing
factor to the emergence of resistant bacteria.
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It is widely believed that human malpractices such as inadequate dosing, incomplete courses and
indiscriminate drug use have contributed to the emergence and spread of antimicrobial
resistance.
“Did God who gave us flowers and trees,

Also provide the allergies?”
~ E.Y. Harburg
Allergy is a disorder of the immune system often also referred to as atopy. Allergic reactions

occur to normally harmless environmental substances known as allergens. [Ref 6]
An allergic reaction occurs when the immune system begins to recognize a drug as something
"foreign". Antibiotics, especially the penicillin and sulphonamides, account for a large
proportion of allergic drug reactions. Allergic reactions commonly have the following
symptoms:
 Shortness of breath
 Hives
 Itching
 Swelling of your lips, face, or tongue
 Fainting
Several different symptoms can indicate that a person is allergic to penicillin. These include:
[Ref 7]
 Hives (raised, intensely itchy spots that come and go over hours)
 Angioedema (swelling of the tissue under the skin, commonly around the face),
 Wheezing and coughing from asthma-like reactions (narrowing of the airways into the
lungs).
Serious allergies to penicillin are common, with about 10 percent of people reporting an
allergy. This is also one of the reasons why self-medication should be avoided.
“The appearance of a disease is swift as an arrow; its disappearance slow, like a thread”.
~ Chinese Proverb
This impatience is the main reason why patients often don’t complete their course of Antibiotics.
They are unaware of the fact that by not completing their course of Antibiotics, they are
imposing a danger to their health & the illness can occur again. It is essential to completely
15
render the causative organism inactive so that it does not reproduce or show effects again by
following the course of Antibiotics along with proper instructions & precautions.
SELF- MEDICATION
“Every patient carries her or his own doctor inside”.

~ Albert Schweitzer
Self-medication can be defined as the use of drugs to treat self-diagnosed disorders or symptoms,
or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or
symptoms. It is usually selected by consumers for symptoms that they regard as troublesome to
require drug therapy but not to justify the consultation of a prescriber. In developing countries,
most illnesses are treated by self-medication.
It has been noticed that people often practice self-medication and consume medicines on the
basis of their knowledge, which they think is sufficient, or by just referring a chemist/druggist.
They either consult a chemist and obtain a medicine from his shelf, or may consult a neighbour
who may be having some tablets left over from his previous illness, and readily spares them.
They don’t prefer to consult a physician, due to many reasons. This practice may be harmful to
the patient.
Fever, cold, cough, constipation or indigestion is among the usual cases of self-medication. The
mostly misused drugs are analgesics or pain relievers.
A major shortfall of self-medication is the lack of clinical evaluation of the condition by a

trained medical professional, which could result in missed diagnosis and delays in appropriate
treatments.
A major problem with self-medication with antimicrobials is the emergence of human pathogens
resistance. Self-medication with antibiotics may increase the risk of inappropriate use and the
selection of resistant bacteria. One of the triggers for using self-medication may be past
experience with antibiotics prescribed by health professionals.
Safety issues include concerns relating to age of the user, pregnancy, underlying disease and the
potential for drug interactions.
Factors That Influence the Tendency of Self-Medication
16
 Patient education, socio-economic status, gender and age appear the major factors
associated with self-prescription of the medicines.
 The availability of antimicrobial agents for self-medication may increase and could
include antibacterial agents for oral or topical use.
 Changed regulation from Prescription-Only Medicine (POM) to Pharmacy (P) medicine

of selected agents with indications for short-term use in specific minor infections and
illness is likely to have advantages to the user. However, safeguards to their use would
need to be included in the Patient Information Leaflet (PIL).
“If your body's not right, the rest of your day will go all wrong. Take care of yourself.”
~ Terri Guillemets
PROBLEM STATEMENT
Recent trends reveal an exponential increase in the practise of self-medication being followed in
India still, especially in the case of Antibiotics.
This practice is followed by the chemists/druggists/pharmacists to earn more profits and reduce
wastage of time & labour.
The patients take Antibiotics without referring to any physician so as to save money & time.
Also in some cases they feel that the doctors waste their money by prescribing too many
medicines, some of which they consider are unnecessary. Some other socioeconomic &
environmental factors are also seems to be influencing the practise of self-medication in India.
However, the important questions are”
“Is this practice of self-medication still prevalent in India?”
“Is this practice fair on the chemists’/druggists’/pharmacists’ part?”
“How far is it justified to take risk with the health of the patients?”
This project intends to do a comparative research to address this by analyzing the various facets
involved.
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RESEARCH OBJECTIVES
The Objective of this research is to study the prevalence of practise of self-medication of

Antibiotics in M.P. State, India.
The Scope of this research includes:
 Analyzing the current scenario.

 Testing the knowledge & perceptions of patients regarding Antibiotics.
 Knowing the Doctor’s point of view in this case.
 Understanding the chemists’/druggists’/pharmacists’ behaviour.
 Analysis of the measures needed to be taken.
The Limitations of this research includes:
 Responses may be subjected to bias.

 Cannot get full access to customer thoughts.
 Lack of respondent willingness to follow instructions.
 Busy schedules of the doctors due to which many responses may not be attained.
 Respondents may hide actual habits & practices.
 Ignorance of patients.
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CHAPTER 2: LITERATURE REVIEW
“If a runny nose and congested chest have you thinking of antibiotics, think again.”
~ ScienceDaily (Jan. 18, 2005)
STUDIES EXPLORING ANTIBIOTIC MISUSE
“For uncomplicated colds, zero are necessary; bronchitis, less than 10 percent are necessary; sore
throats, maybe up to 10 to 15 percent of these patients need an antibiotic,” - Dr. Jim Wilde,
paediatric emergency medicine and infectious disease physician at the Medical College of
Georgia. [Ref 7]
“Ninety to 95 percent of all infections are viral or low-acuity bacterial infections such as ear
infections or sinus infections,” - Dr. Wilde. Yet studies show that more than half of patients in
the United States are taking bacteria-destroying antibiotics for colds, flu and bronchitis, all
caused by viruses - Dr. Wilde.
Scientists & doctors believe that without big change, antibiotics - needed to treat life-threatening
conditions such as meningitis and pneumonia - may be useless within 50 years.
Third-world countries, where severe physician shortages preclude prescriptions for antibiotics,
already are living the nightmare of common infections that no longer have a treatment.
Antibiotics Use Linked To Asthma
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A study was conducted by Dr. Kozyrskyj and colleagues from the University of Manitoba and
McGill, University in Montreal on “Antibiotics Use in Infants Linked To Asthma” to study the
linkages of asthma occurrence to antibiotic usage in infants. [Ref 8]
The reason for antibiotic use was categorized by lower respiratory tract infection (bronchitis,
pneumonia), upper respiratory tract infection (otitis media, sinusitis), and nonrespiratory tract
infection (urinary infections, impetigo). Risk and protective factors also were noted, including
gender, urban or rural location, neighbourhood income, number of siblings at age 7, maternal
history of asthma, and pets reported living in the home.
Results showed that antibiotic use in the first year was significantly associated with greater odds
of asthma at age 7. This likelihood increased with the number of antibiotic courses, with children
receiving more than four courses of antibiotics having 1.5 times the risk of asthma compared
with children not receiving antibiotics.
 When researchers compared the reason for antibiotic use, their analysis indicated that
asthma at age 7 was almost twice as likely in children receiving an antibiotic for
nonrespiratory tract infections compared with children who did not receive antibiotics.
 Maternal asthma and presence of a dog during the first year of life were both associated
with asthma risk.
 Children who received multiple antibiotic courses and who were born to women without
a history of asthma were twice as likely to develop asthma as those not receiving
antibiotics.
 Furthermore, absence of a dog during the birth-year doubled asthma risk among children
taking multiple courses of antibiotics.
Socioeconomic and Behavioral Factors

A study conducted by Iruka N. Okeke, Adebayo Lamikanra, and Robert Edelman; Obafemi
Awolowo University, Ile-Ife, Nigeria; and .University of Maryland School of Medicine,
Baltimore, Maryland, USA on “Socioeconomic and Behavioral Factors Leading to Acquired
Bacterial Resistance to Antibiotics in Developing Countries”. [Ref 9]
In developing countries, acquired bacterial resistance to antimicrobial agents is common in
isolates from healthy persons and from persons with community-acquired infections. Complex
socioeconomic and behavioral factors associated with antibiotic resistance, particularly regarding
diarrheal and respiratory pathogens, in developing tropical countries, include:
 Misuse of antibiotics by health professionals, unskilled practitioners, and laypersons;

 Poor drug quality & lack of quality compliance and monitoring;
 Degraded antibiotics
 Expired antibiotics
 Counterfeit antibiotics
 Adulterated antibiotics
 Unhygienic conditions accounting for spread of resistant bacteria;
 Inadequate Hospital Infection Control Practices; and
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 Inadequate surveillance.
Misuse of Antibiotic as Cause of Resistance

The perception that antibiotic resistance is primarily the undesirable consequence of antibiotic
abuse or misuse is a view that is simplistic and inaccurate, according to a recent report by the
American Academy of Microbiology on “Misuse Of Antibiotic Not the Only Cause of
Resistance”. [Ref 10]
The reasons behind the spread of resistance are much more complex, including appropriate
antibiotic use, lack of proper sanitation and hygiene, and even the environment.
Antibiotic resistance is an international pandemic that compromises the treatment of all
infectious diseases. At the present time, resistance essentially is uncontrollable. The reasons
behind the establishment and spread of resistance are complex, mostly multi-factorial, and
mostly unknown.
Resistance is often portrayed as simply an undesirable consequence of antibiotic abuse or
misuse, but the rate of antibiotic resistance emergence is related to all uses of drugs, not just
misuse, and the total amount of antibiotics used and the environment also play roles. The main
driving factor behind resistance may actually be a lack of adequate hygiene and sanitation, which
enables rapid proliferation and spread of pathogens.
SELF-MEDICATION WITH ANTIBIOTICS

Self-medication with antibiotics may increase the risk of inappropriate use and the selection of
resistant bacteria. One of the triggers for using self-medication may be past experience with
antibiotics prescribed by health professionals. We examined the association between prescribed
use and self-medication with antibiotics
Is Self-Medication With Antibiotics In Europe Driven By Prescribed Use?

A study shows that source of self-medication is leftover antibiotics bought on prescription for
specific disease/symptom. The result of the study: [Ref 11]
 The association between prescribed use and self-medication was modified by source of
self-medication, region in Europe and education.
 This association was consistently stronger for self-medication from leftovers than from
other sources, primarily directly from a pharmacy.
 It was stronger also for respondents from Northern/Western Europe than respondents
from Eastern Europe and Southern Europe and those with low education.
 Prescribed use for URTIs (minor ailments such as throat symptom, influenza, etc.)
increased the likelihood of self-medication with leftover antibiotics for these
symptoms/diseases in all European regions.
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Prevalence of Self-Medication in STD Patients

A research was conducted by Centers for Disease Control and Prevention, National Center for
Prevention Services, Atlanta, Georgia to ascertain the prevalence of self-medication with
antimicrobial agents among patients attending a clinic for treatment of sexually transmitted
diseases (STDs). [Ref 12]
For this the researchers collected a urine specimen for antimicrobial testing from 551 patients
before treatment. They defined self-medication as an antimicrobial agent taken on the patient's
own initiative by self-report during the week before the visit to the clinic or a positive urine
assay for antimicrobial agents at the time of the clinic visit.
Results of the study are:
 A total of 75 (14%) of the 551 participants were self-medicators,

 19 reported antimicrobial use and had a positive urine test,
 27 reported antimicrobial use but had a negative urine test, and
 29 denied antimicrobial use but had a positive urine test.
Thus, 29 (60%) of the 48 patients with antimicrobial agents detected in their urine at the time of
the clinic visit denied self-medication.
 Self-medicators acquired their antibiotics either from their medicine cabinet (44%) or
from a family member or friend (56%).
 Self-medication was associated with self-report of prior use of unprescribed antimicrobial
agents (P < .0001).
They concluded that use of unprescribed antimicrobial agents (usually beta-lactam agents or
tetracyclines) among STD clinic attendees in the study was common and that self-reporting was
not a reliable method of screening for self-medicators.
International Journal of STD & AIDS:

One of the health education messages given in sexually transmitted disease (STD) control is
patients' adopting appropriate health seeking behaviour. This includes reporting to health
facilities for appropriate diagnosis and treatment. In parts of the world where STD etiologic
agents have assumed resistance to commonly used antimicrobials, this is important. [Ref 13]
Results of the study:
 The antimicrobial self medication practices of 764 patients attending an STD clinic in a
developing country were studied.
 Seventy-four and a half per cent admitted to self medication before reporting to the clinic.
22
 The antibiotics taken in inappropriate dosages were purchased over the counter, given by
friends or were 'left-overs' from previous medications.
In the fight to control STD spread as a means of reducing the incidence of HIV/AIDS,
indiscriminate use of antimicrobials needs to be guarded against.
SELF-MEDICATION IN INDIA
A survey to study self-medication practise in India was conducted by Department of Prev. &
Social Medicine, Govt. Medical College, Nagpur, India, according to Indian Journal of Medical
Sciences. [Ref 14]
Some of the findings are:
 Out of 323 persons visiting the 3 medical shops, 104 (31%) per sons purchased the drugs
without prescription.
 Amongst the persons buying the drugs without prescription, 32(30.8%) were aged 41-50
years while 28(26.9%) were aged 31-40 years.
 Literacy status of persons practising self medication was mainly illiterate (23.1%) and
graduate or above (26%). 27 persons (26%) buying drugs without prescription were of
labour class while 20 (19.3%) were businessmen.
 Cough and cold was the most common complaints for self medication (22.2%) followed
by fever (17.4%), boils (7.6%), acidity (6.8%), joint pain (6.8%) etc.
 Analgesics and antipyretics were most commonly sold drugs on self prescription (30.9%)
followed by tonics or vitamin preparation (16.1%), antibiotics (10.7%), antacids (6.8%)
and cough syrup (5.4%). [Table 1]
 Total 149 categories of drugs were used for medication of 144 complaints in 104 persons.
 Out of 104 self medicating per sons 32(30.8%) got the information about drugs from
friends or neighbours, 24(23.1%) from chemist while 19(18.3%) bought the drugs
because it was once prescribed by doctor. [Table 2]
 Out of 104 persons only 2 knew the action and side effects of the drug while 72 persons
were also using some other drugs themselves. Out of these 104, 90 persons felt that self
medication is wrong but still were practising it.
Table 1: Distribution of Drugs Sold On Self-Prescription
S. No. Complaints Number Percentage
1. Analgesics 46 30.9
2. Tonics/Vitamins/Antipyretics 24 16.1
23
3. Antibiotics 16 10.7
4. Antacids 10 6.8
5. Cough Syrup 8 5.4
6. Eye Drops 6 4.0
7. Anti-diarrhoeal 6 4.0
8. Anti-allergic 5 3.4
9. Anti-spasmodic 4 2.7
10. Anti-amoebic 4 2.7
11. Nasal Decongestant 4 2.7
12. Anti-hypertensive 4 2.7
13. Anti-malarial 3 2.0
14. Anti-fungal 3 2.0
15. Anti-helmenthic 2 1.3
16. Purgatives 2 1.3
17. Sedatives 2 1.3
Table 2: Source of Information about the Drug
S. No. Source Number Percentage
1. Once Prescribed 19 18.3
2. Mass Media 12 11.5
3. Friends/Neighbours 32 30.8
4. Family members 17 16.3
5. Chemist 24 23.1
24
Social Factors Leading To Self-Medication in India

A research was conducted by researchers from Clinical Epidemiology Unit, Medical College,
Trivandrum, Kerala, India; Centre for Clinical Epidemiology and Biostatistics, The University of
Newcastle, Callagham, Australia and Department of Anthropology, University of Arizona, USA
to study the “Social factors influencing the acquisition of antibiotics without prescription in
Kerala State, South India”. [Ref 15]
The research included survey by random sampling of 400 households in one primary health
centre area near Trivandrum.
Results of the research are:
 69.3% (95% CI=64.8–73.8) of households had at least one person using a pharmaceutical
product during the two-week recall period; antibiotics formed almost 11% of the
medicines consumed.
 Pharmacy based interview and observation data were collected from 405 antibiotic
purchasers sampled from 11 out of the 12 private pharmacies in the area. Seventy-three
of these 405 customers purchased antibiotics without a prescription (18%; 95%).
 By combining the household survey and pharmacy observations, it was estimated that
almost half of 1% (0.41%; 95%) of the population, or four people per 1000, is engaged in
self-medication using antibiotics in Kerala in any two-week period.
 The data show that people least likely to follow this practice are
 from higher income families,

 Having more education and higher status occupations and
 Receiving the benefits of medical insurance.
Conversely, logistic regression analysis indicated that risk of buying antibiotics without a script
was associated with education at secondary level or below, the perception that it is expensive to
consult a doctor and low satisfaction with medical practitioners. Keralites' self-medication
patterns are interpreted broadly using social, cultural, historical and economic perspectives.
Drug Prescription and Self-Medication in India

A study was conducted by a researcher from UK regarding study of self-medication in India.
[Ref 16]
This report included a study of the prescribing and dispensing of drugs in India. The drugs
supplied to 2400 patients by the public and private medical sectors and by private pharmacies
(over the counter dispensing) were recorded, and were analyzed with respect to the patient's
presenting complaint and diagnosis.
25
The main findings are:
 Large numbers of drugs are prescribed by doctors in the private sector. Combination
preparations containing ‘hidden’ classes of drug are often given. Anti-infective are widely
and often inappropriately used.
 Potentially dangerous drugs are sold over the counter and prescribed for trivial or bizarre
indications. Drugs which have been withdrawn as dangerous in the West remain popular
first line drugs in India.
 Food supplements and tonics of dubious nutritional and pharmacological value make up a
high proportion of the total drugs bill.
It is concluded that a rational drugs policy and/or an essential drugs list will be useless unless
accompanied by intensive efforts to improve the education and updating of doctors and
pharmacists and to reduce the commercial pressures on doctors to prescribe unnecessary drugs.
Pharmacies, Self-Medication and Pharmaceutical Marketing in Bombay, India

A research conducted by researchers from Department of Anthropology, Emory University, ,
Atlanta, USA and Department of Anthropology, University of Arizona, AZ, USA to study the
practice of self-medication being encouraged by pharmacies in India. [Ref 17]
Studies of pharmaceutical practice have called attention to the role played by pharmacists and
pharmacy attendants in fostering self-medication and medicine experimentation among the
public. Left undocumented is the extent to which clients passively follow the advice of pharmacy
personnel or question their motive or expertise.
While research has focused on pharmacists and pharmacy attendants as agents encouraging self-
medication and medicine experimentation, adequate attention has not been paid to pharmacist–
client interactions that are sensitive to the social, cultural, and economic context in which
medicine sales and advice occur. This paper highlights the context in which pharmacy attendants
engage in “prescribing medicines” to the public in Bombay, India.
An ethnographic description of pharmacies and pharmaceutical-related behaviour in Bombay is
provided to demonstrate how reciprocal relationships between pharmacy owners, medicine
wholesalers and pharmaceutical sales representatives (MRs) influence the actions of pharmacy
staff. Attention is focused on the role of the medicine marketing and distribution system in
fostering prescription practice, pharmacy “counter-pushing” and self-medication.
In documenting the profit motives of different players located on the drug sales continuum, it is
argued that the economic rationale and the symbiotic relations that exist between doctors, MRs,
medicine wholesalers and retailers, need to be more closely scrutinized by those advocating
“rational drug use”.
26
STATISTICS
• Currently, the pharmaceutical industry in India is a $ 10 billion industry, growing at a

rate of around 10% annually.
• Indian pharmaceutical industry ranks 4th in terms of volume and 13th in terms of value.
• Around 8% of the world’s drugs are manufactured in India.
• India has 300 pharmaceutical companies of large and moderate size and another 10,000
small and tiny firms.
• But 70% of the production is by the top 100 larger companies.
• The industry is highly fragmented, with the largest formulation players having a market
share of less than 6%.
• The industry manufactures about 400 bulk drugs and almost the entire range of
formulations.
CHAPTER 3: STUDY DESIGN & METHODOLOGY
DATA COLLECTION METHOD
27
 Primary Data
For my research purpose, I have used the questionnaire survey method to conduct the
analysis. Questionnaires are of three categories such as structured, un-structured,
disguised and undisguised. The appropriate category was chosen for designing the final
questionnaire.
 Pretesting Of Questionnaire
A pilot study was conducted by distributing a model questionnaire to a small sample
group. Based on the doubts raised by the respondents, the questionnaire was modified
accordingly.
 Secondary Data
Secondary data collection was done through the use of websites and health journals.
DATA SOURCES
 Primary Data Source: Collected using questionnaires, direct interviews and

web/e-mail surveys.
 Secondary Data Source: Literature reviews.
RESEARCH INSTRUMENTS
 Close ended questionnaires to obtain primary data.

 Online Research
 Face to face Interview
 Observation
 Experience Surveys
SAMPLING DESIGN
Simple Random Sampling & Cluster Sampling
PERIOD COVERED BY THE STUDY
 From April 5th to April 20th, 2010.
28
SAMPLING UNIT
For sampling, the Sampling Unit selected was Saugor (M.P.), Bhopal (M.P.), and Indore (M.P.)
to ensure availability of data from a diverse group. The sampling unit would include
 People of various occupation, income groups & education standards who are the
patients visiting chemist shops or doctors.
 Chemists/druggists/pharmacists owning or employed in retail
chemist/drug/pharma shops.
 Doctors & medical students of various medical course.
SAMPLE SIZE
 A sample size of 100 in case of patients & pharmacists would be the focus of
study.
 A sample size of 50 in case of doctors & medical students would be the focus of
study.
SURVEY METHOD
The survey is a non-experimental, descriptive research method. Surveys can be useful when a
researcher wants to collect data on phenomena that cannot be directly observed (such as opinions
on medical services). Surveys are used extensively in library and information science to assess
attitudes and characteristics of a wide range of subjects, from the quality of user-system
interfaces to library user reading habits.
TYPES OF SURVEYS
Data are usually collected through the use of questionnaires, although sometimes researchers
directly interview subjects. Surveys can use qualitative (e.g. ask open-ended questions) or
quantitative (e.g. use forced-choice questions) measures. There are two basic types of surveys:
cross-sectional surveys and longitudinal surveys.
 Cross-Sectional Surveys
Cross-sectional surveys are used to gather information on a population at a single point
in time. An example of a cross sectional survey would be a questionnaire that collects
data on how parents feel about Internet filtering, as of March of 1999. A different cross-
sectional survey questionnaire might try to determine the relationship between two
factors, like religiousness of parents and views on Internet filtering.
 Longitudinal Surveys
29
Longitudinal surveys gather data over a period of time. The researcher may then analyze
changes in the population and attempt to describe and/or explain them. The three main
types of longitudinal surveys are trend studies, cohort studies, and panel studies.
 Trend Studies
Trend studies focus on a particular population, which is sampled and scrutinized
repeatedly. While samples are of the same population, they are typically not composed of
the same people. Trend studies, since they may be conducted over a long period of time,
do not have to be conducted by just one researcher or research project. A researcher may
combine data from several studies of the same population in order to show a trend.
 Cohort Studies
Cohort studies also focus on a particular population, sampled and studied more than once.
But cohort studies have a different focus.
 Panel Studies
Panel studies allow the researcher to find out why changes in the population are
occurring, since they use the same sample of people every time. That sample is called a
panel.
EXPERIMENT METHOD
The experimental method involves manipulating one variable to determine if changes in one
variable cause changes in another variable. This method relies on controlled methods, random
assignment and the manipulation of variables to test a hypothesis. An experiment is a study of
cause and effect.
 The Field Experiment

Sometimes it is possible to carry out experiments in a more natural setting, i.e. in ‘the
field ’. A famous example of this is the series of studies carried out by Piliavin et al
(1969) in which they arranged for a person to collapse on an underground train and
waited to see how long it was before the person was helped. One of the independent
variables they used was the appearance of the ‘victim’: whether he was carrying a
walking stick or whether he appeared to be drunk.
As with the laboratory experiment, the independent variable is still deliberately

manipulated by the researcher. However it is not possible to have such tight control over
variables in the field, but it does have the advantage of being far less artificial than the
laboratory.
ACTION PLAN FOLLOWED
30
FLOWCHART: 1
Prepare a Draft
Literature Review
Finalizing the parts of city
Take permission from retail pharma stores/doctors
Data Collection
Questionnaires Survey
Interviews
Report
Statistics, Findings & Conclusion
Recommendations
31
CHAPTER 4: PRESENTATION & ANALYSIS OF DATA
SOFTWARE USED
The Software SPSS Statistics 17.0 was by our team to analyze the data collected from the
surveys conducted as part of the study. The latest version of this software application is IBM
SPSS Statistics 18
FIGURE: 1
SPSS provides the tools you need to speed through every stage of your statistical research and
reach accurate results, even if you work with complex or difficult data. The various features
available are:-
Features for Data Preparation
 Data validation rules and/or Automatic Data Preparation help you validate complex data
more easily.
 Multiple imputation procedures allow you to develop reliable estimates for missing data
and create more accurate models.
 Data transformations prepare your data for advanced analyses.
Features for Analysis
32
 Optimal binning.
 Nonlinear and multivariate analysis.
 Survival analysis algorithms.
 General linear models with repeated measures.
Features for Reporting

 Create custom tables that present results clearly.
 Use new post-compute feature to create additional categories even after your data has
been tabulated.
FIGURE: 2
MAIN HYPOTHESIS: Prevalence of the practise of self-medication of Antibiotics in M.P.

State, India.
DATA CHARACTERISTICS
Findings & Interpretation: The respondents are majorly professionals (27.3%). Home makers
(18.2%), students (18.2) and businessmen (18.2%) constitute a significant & equal portion of the
sample, while freelancer is the least (9.1). Hence from the chart it is clear that the majority of the
respondents to the survey conducted were professionals. [Pie Chart 1]
33
PIE CHART: 1
PERCENTAGE OF ANTIBIOTICS USERS
Hypothesis 1: There is a rising trend towards usage of Antibiotics with or without prescription.
Findings & Interpretation: All of the respondents- patients, pharmacists as well as doctors-
have consumed Antibiotics in their life (100 % Yes). This probably reflects the increased usage
of Antibiotics for general or specific ailments, with or without prescription, among all sections of
society in M.P. State of India. [Pie Chart 2]
PIE CHART: 2
34
FREQUENCY OF USAGE OF ANTIBIOTICS
Hypothesis 2: The frequency of usage of Antibiotics with or without prescription has been
increased.
Findings & Interpretation: Majority of the respondents- patients, pharmacists & doctors use
Antibiotics often. While responses of never before were neglible.
Among patients- responses for often use antibiotics were the maximum (54.5%), while that of
very often & sometimes were equal (18.2% each). But responses for never used were not
received. [Pie Chart 3]
PIE CHART: 3
Among pharmacists- responses for often use antibiotics were the maximum (52%), while that of
sometimes (27 %) and very often (12 %) were found. But responses for never before (9%) were
the least received among pharmacist. [Pie Chart 4]
PIE CHART: 4
35
Among doctors- responses for often use antibiotics were the maximum (50%), while that of very
often (30 %) & sometimes (20 %) were found. But responses for never used were not received
among doctors too. [Pie Chart 5]
PIE CHART: 5
PATIENT AWARENESS – Further Analysis
Hypothesis 3: Effect of awareness among patients about side-effects & allergies of antibiotics
on their behaviour of referring a doctor before taking antibiotics.
Findings & Interpretation: [Table 3, 4, 5 & 6]

 From Table 3, it can be inferred that out of those people who have used antibiotics in
their life, 60% have referred a doctor before taking antibiotics. While 40% of them had
taken antibiotics without consulting a doctor. [Bar Chart: 1]
 From Table 4, it is seen that 83.3% of patients who consulted a doctor knew the side-
effects caused by antibiotics & that explains why they referred doctor before consuming
antibiotics. While 16.7 % of them didn’t know that antibiotics cause side-effects but
referred a doctor before consuming antibiotics.
 But 25% of the patients who didn’t consulted doctor knew that antibiotics cause side-
effects, still they didn’t refer doctor before consuming antibiotics.
 While 75% of them didn’t know any side-effects of antibiotics and that can probably
explain the reason why they didn’t refer a doctor before taking antibiotics.
 From Table 5, it can be inferred that most of the people don’t consult a doctor before
taking antibiotics since it has highest mean value (2.000).
 From Table 6, it can said that there is no significant difference of means of knowledge of
side-effects of antibiotics in the referring to a doctor before taking antibiotics (p>0.05).
36
TABLE: 3
Crosstabulation
Have you ever taken antibiotics? * Have you referred a doctor before taking antibiotics?
hvureferddoctorb4tkingAB
Yes No Total
hvuevertakenantibiotics Yes Count 60 40 100
% within 60.0% 40.0% 100.0%

hvuevertakenantibiotics
% within 100.0% 100.0% 100.0%

% of Total 60.0% 40.0% 100.0%
Std. Residual .0 .0
Total Count 60 40 100
% within 60.0% 40.0% 100.0%

% within 100.0% 100.0% 100.0%

% of Total 60.0% 40.0% 100.0%
BAR CHART: 1
37
TABLE: 4
Crosstabulation
Have you referred a doctor before taking Antibiotics? * Do you know any side-effects of Antibiotics?
douknwanysideeffctsofAB
Yes No Don't Know Total
hvureferddoctorb4tkingAB Yes Count 50 0 10 60
% within 83.3% .0% 16.7% 100.0%

No Count 10 30 0 40
% within 25.0% 75.0% .0% 100.0%

Total Count 60 30 10 100
% within 60.0% 30.0% 10.0% 100.0%

TABLE: 5
Descriptives
Have you referred a doctor before taking Antibiotics?
95% Confidence Interval for Mean
N Mean Std. Deviation Std. Error Lower Bound Upper Bound Minimum Maximum
Yes 6 1.1667 .40825 .16667 .7382 1.5951 1.00 2.00
No 3 2.0000 .00000 .00000 2.0000 2.0000 2.00 2.00
Don't 1 1.0000 . . . . 1.00 1.00

Know
Total 10 1.4000 .51640 .16330 1.0306 1.7694 1.00 2.00
38
TABLE:6
ANOVA
Have you referred a doctor before taking Antibiotics?
Sum of Squares df Mean Square F Sig.
Between Groups (Combined) .433 2 .217 .771 .498
LUnweighted .408 1 .408 1.453 .267

i
Weighted .426 1 .426 1.517 .258
n
Deviation .007 1 .007 .025 .879
e
a
r
T
e
r
m
Within Groups 1.967 7 .281
Total 2.400 9
39
Findings & Interpretation: [Table 7]
 It is observed that 66.7% of the patients who referred a doctor before consuming antibiotics
have some allergy from any antibiotics. 16.7 % of them didn’t know if they have any or not,
while rest 16.7% didn’t know that antibiotics even cause allergy.
 25% of the patients who didn’t refer a doctor have some kind of allergy from antibiotics; still
they didn’t consult a doctor before consuming antibiotics. 25% of them didn’t know any
allergies caused by antibiotics while rest 50% didn’t even know that antibiotics cause allergy
which probably explains the reason of their behaviour.
TABLE: 7
Crosstabulation
Have you referred a doctor before taking antibiotics? * Do you have allergy from antibiotics?
douhvallergyofAB

hvureferddoctorb4tkingAB Yes Count 40 10 10 60
% within 66.7% 16.7% 16.7% 100.0%
No Count 10 10 20 40
% within 25.0% 25.0% 50.0% 100.0%
% within 50.0% 20.0% 30.0% 100.0%
Hypothesis 4: The awareness among patients about correct practise to be followed in case of
antibiotics on their behaviour of referring a doctor before its consumption.
 It is seen that out of people who think it’s correct to take antibiotics from a chemist
without doctor’s prescription, 60% referred a doctor before taking antibiotics while rest
40% didn’t. [Bar Chart: 2]
 Similar percentage is found among people who think it is not correct. Thus we can say
that 40% of people in spite of knowing that it is wrong took antibiotics without
consulting a doctor.
TABLE: 8
Crosstabulation
Is it correct to take antibiotics without prescription? * Have you referred a doctor before taking antibiotics?
40
Yes No Total
correcttotkABfrmchemistwtho Yes Count 30 20 50

utpresc
% within 60.0% 40.0% 100.0%
correcttotkABfrmchemistwtho
utpresc
% within 50.0% 50.0% 50.0%

% of Total 30.0% 20.0% 50.0%
Std. Residual .0 .0
No Count 30 20 50
% within 60.0% 40.0% 100.0%

utpresc
% within 50.0% 50.0% 50.0%

% of Total 30.0% 20.0% 50.0%
Std. Residual .0 .0
% within 60.0% 40.0% 100.0%

utpresc
% within 100.0% 100.0% 100.0%

% of Total 60.0% 40.0% 100.0%
BAR CHART: 2
41
 It can be inferred that out of those people who said that they always finish their course of
antibiotics, 66.7% knew that antibiotic resistant bacteria is likely to reoccur if patient
doesn’t complete his course of antibiotics. While 33.3% of them said that reoccurrence of
disease doesn’t depend on finishing of course, but still finished their course may be
following doctor’s instruction.
 Out of people who often finish their antibiotics course, 40% didn’t know about
reoccurrence of antibiotics resistant bacteria. While 60% of them said that reoccurrence
of disease doesn’t depend on finishing of course.
 Out of those who sometimes complete their antibiotics course, 50% knew about antibiotic
resistant bacteria being the reason of reoccurrence of disease. While rest 50% didn’t
know about bacteria, probably explaining the reason why they don’t finish their course of
antibiotics.
TABLE: 9
Crosstabulation
42
Do you finish your course of antibiotics? * Antibiotic resistant bacteria likely to occur if people don’t finish their course of antibiotics?
ABresbaclikelytooccureifppldntfinishcourse
doufinishurcourseofAB Always Count 20 10 0 30
% within 66.7% 33.3% .0% 100.0%

doufinishurcourseofAB
Often Count 0 30 20 50
% within .0% 60.0% 40.0% 100.0%

Sometimes Count 10 0 10 20
% within 50.0% .0% 50.0% 100.0%

% within 30.0% 40.0% 30.0% 100.0%

EDUCATION AS A FACTOR OF SELF-MEDICATION

Hypothesis 5: To find whether education is a factor influencing behavior towards misuse & self-
medication of antibiotics.
 It can be inferred from the table that out of the people whose highest level of education
was undergraduate, 100% didn’t refer a doctor before taking antibiotics. This clearly
explains the reason of their behavior & increasing cases of misuse of antibiotics.
 Out of people with highest education as graduation, 53.4% didn’t refer a doctor before
taking antibiotics.
 Out of post-graduated people, only 14.3% consumed antibiotics without consulting a
doctor.
 Out of people who have done doctorate, 87.5% didn’t refer a doctor before taking
antibiotics. Here the reason may be attributed as their own knowledge about medicines.
TABLE: 10
Crosstabulation
Highest level of education? * Have you referred a doctor before taking antibiotics?
hvureferddoctorb4tkingAB Total
43
Yes No
Highestlevelofeducation Undergraduate Count 0 6 6
% within .0% 100.0% 100.0%

Highestlevelofeducation
Graduate Count 27 31 58
% within 46.6% 53.4% 100.0%

Post Graduate Count 24 4 28
% within 85.7% 14.3% 100.0%

Doctorate Count 1 7 8
% within 12.5% 87.5% 100.0%

% within 52.0% 48.0% 100.0%

Ailments Commonly Subjected To Self-Medication:
 According to people/patients, the ailments for which they take antibiotics without
referring a doctor or a pharmacist are headache (36.4%), body ache (27.3%) while fever,
tonsillitis & abdominal disorder all had equal percent (9.1). [Pie Chart 6]
 According to people/patients, the ailments for which they take antibiotics without
referring a doctor by just seeking a pharmacist’s/chemist’s advice are fever (27.3%),
body ache & abdominal disorder (18.2%) while body ache, tonsillitis & any other all had
equal percent (9.1). [Pie Chart 7]
PIE CHART: 6
44
PIE CHART: 7
PHARMACIST/CHEMIST RESPONSIVENESS
Hypothesis 6: The attitude of pharmacists/chemists towards self-administration of antibiotics.
45
Findings & Interpretation:
 Out of the responses received from the chemists/pharmacists, 88% have taken antibiotics
in their life, 8% haven’t while 4% didn’t know about it. [Table 11]
 40.9% among those who have taken antibiotics in their life have referred a doctor before
taking antibiotics while 59.1% didn’t consult one. [Table 12]
 58.3% of those who consume antibiotics very often don’t refer a doctor before taking
them while 59.1% of those who often take antibiotics don’t refer a doctor. 77.8% of those
consume only sometimes don’t refer a doctor.[Table 13]
TABLE: 11
Have you ever taken antibiotics?
Cumulative
Frequency Percent Valid Percent Percent
Valid Yes 88 88.0 88.0 88.0
No 8 8.0 8.0 96.0
Don't Know 4 4.0 4.0 100.0
Total 100 100.0 100.0
TABLE: 12
Crosstabulation
Have you ever taken antibiotics? * Have you referred a doctor before taking antibiotics?
Yes No Total
hvuevertakenantibiotics Yes Count 36 52 88
% within 40.9% 59.1% 100.0%
No Count 1 7 8
% within 12.5% 87.5% 100.0%
Don't Know Count 0 4 4
% within .0% 100.0% 100.0%
% within 37.0% 63.0% 100.0%
BAR CHART: 3
46
TABLE: 13
Crosstabulation
How often do you take antibiotics?* Have you referred a doctor before taking antibiotics?
Yes No Total
hwoftendoutkantibiotics Very Often Count 5 7 12
% within 41.7% 58.3% 100.0%

hwoftendoutkantibiotics
Often Count 25 27 52
% within 48.1% 51.9% 100.0%

Sometimes Count 6 21 27
% within 22.2% 77.8% 100.0%

Never Before Count 1 8 9
% within 11.1% 88.9% 100.0%

% within 37.0% 63.0% 100.0%

BAR CHART: 4
47
Hypothesis 7: Sense of morality among chemists/pharmacists towards dispensing of antibiotics

without doctor’s prescription.
Findings & Interpretation:
 66% of chemists/pharmacists agree & 6% strongly agree that there should be a strict law
against dispensing antibiotics over the counter without checking doctor’s prescription
while 25% disagree & 3% strongly disagree with that. [Table 14]
 62.5% of the pharmacists/chemists who think it’s not fair on chemist’s part to dispense
antibiotics without doctor’s prescription provide antibiotics strictly on prescription only,
while 37.5% of those think it’s fair. [Table 15]
TABLE: 14
There should be a strict law against prescribing antibiotics without prescription?
Cumulative
Valid Stronlgy Agree 6 6.0 6.0 6.0
Agree 66 66.0 66.0 72.0
Disagree 25 25.0 25.0 97.0
Strongly disagree 3 3.0 3.0 100.0
Total 100 100.0 100.0

TABLE: 15
48
Crosstabulation
Do you strictly provide antibiotics only on prescription? * Is it fair on chemist’s part to dispense
antibiotics without doctor’s prescription?
faironchemistparttogvABwthoutpresc
doustrictlyprovABondocpresc Always Count 3 5 0 8
% within 37.5% 62.5% .0% 100.0%

doustrictlyprovABondocpresc
Often Count 8 61 16 85
% within 9.4% 71.8% 18.8% 100.0%

Sometimes Count 0 6 1 7
% within .0% 85.7% 14.3% 100.0%

% within 11.0% 72.0% 17.0% 100.0%

BAR CHART: 5
Ailments Commonly Subjected To Self-Medication:
49
 According to the chemists/pharmacists, headache (43%), body ache (29%), fever (15%),
abdominal disorder (7%), tonsillitis (5%) & eye infection (1%) are the ailments
commonly subjected to self-medication by patients. [Table 16 & Pie Chart 8]
 According to chemists’/pharmacists, headache (36%), body ache (26%), fever (19%),
abdominal disorder (8%), tonsillitis (6%), eye infection (3%) and any other (2%) are the
ailments commonly used by patients on suggestions or advise from
chemists’/pharmacists. [Table 17& Pie Chart 9]
TABLE: 16
For which ailments patients take antibiotics on the own?

Cumulative
Valid Fever 15 15.0 15.0 15.0
Headache 43 43.0 43.0 58.0
Bodyache 29 29.0 29.0 87.0
Tonsilitis 5 5.0 5.0 92.0
Abdominal Disorder 7 7.0 7.0 99.0
Eye Infection 1 1.0 1.0 100.0
Total 100 100.0 100.0
PIE CHART: 8
TABLE: 17
50
For which ailments do you dispense antibiotics without doctor’s prescription?

Cumulative
Valid Fever 19 19.0 19.0 19.0
Headache 36 36.0 36.0 55.0
Bodyache 26 26.0 26.0 81.0
Tonsilitis 6 6.0 6.0 87.0
Abdominal Disorder 8 8.0 8.0 95.0
Eye Infection 3 3.0 3.0 98.0
Any Other 2 2.0 2.0 100.0
Total 100 100.0 100.0
PIE CHART: 9
51
DOCTOR’S POINT OF VIEW
Hypothesis 8: To find out whether doctors advise their patients not to consume antibiotics
without referring a doctor & thus think its doctor’s or chemist’s duty to guide them.
Findings & Interpretations:
 Out of the doctors who always advise their patients not to take antibiotics without
consulting a doctor, 70% think that it is doctor’s duty to give patients such advice. While
61.5% of those who often advise their patients think it is doctor’s duty.[Table 18]
consulting a doctor, 70% think that it is chemist’s duty to give patients antibiotics only on
doctor’s prescription. While 61.5% of those who often advise their patients think it is
chemist’s duty.[Table 19]
TABLE: 18
Crosstabulation
Do you advise patients not to take antibiotics on their own? * Is it doctor’s duty to advise
patients not to take antibiotics without consulting doctor?
isitdoctorsdutytoadvicepatients
Yes No Total
douadvicepatientsnottotkAB Always Count 21 9 30

withtrefdoc
% within 70.0% 30.0% 100.0%
douadvicepatientsnottotkAB
withtrefdoc
Often Count 8 5 13
% within 61.5% 38.5% 100.0%

withtrefdoc
% within 57.1% 42.9% 100.0%

withtrefdoc
% within 66.0% 34.0% 100.0%

withtrefdoc
52
TABLE: 19
Crosstabulation
Do you advise patients not to take antibiotics on their own? * Is it chemist’s duty to give
antibiotics only on doctor’s prescription?
isitchemistsdutytochkdocpresc
Yes No Total
douadvicepatientsnottotkAB Always Count 21 9 30

withtrefdoc
% within 70.0% 30.0% 100.0%
withtrefdoc
Often Count 9 4 13
% within 69.2% 30.8% 100.0%

withtrefdoc
% within 100.0% .0% 100.0%

withtrefdoc
% within 74.0% 26.0% 100.0%

withtrefdoc
53
CHAPTER: 5 DISCUSSION & INTERPRETATION OF FINDINGS
Main Hypothesis: Prevalence of the practise of self-medication of Antibiotics in M.P. State,

India.
From PIE-CHART: 1
Interpretation and Findings:

The respondents are majorly professionals (27.3%). Home makers (18.2%), students (18.2) and
businessmen (18.2%) constitute a significant & equal portion of the sample, while freelancer is
the least (9.1). Hence from the chart it is clear that the majority of the respondents to the survey
conducted were professionals.
PERCENTAGE OF ANTIBIOTICS USERS
Hypothesis 1: There is a rising trend towards usage of Antibiotics with or without prescription.
From PIE-CHART: 2
Findings & Interpretation: All of the respondents- patients, pharmacists as well as doctors-
have consumed Antibiotics in their life (100 % Yes). This probably reflects the increased usage
of Antibiotics for general or specific ailments, with or without prescription, among all sections of
society in M.P. State of India.
FREQUENCY OF USAGE OF ANTIBIOTICS
Hypothesis 2: The frequency of usage of Antibiotics with or without prescription has been
increased.
Findings: Majority of the respondents- patients, pharmacists & doctors use Antibiotics often.
While responses of never before were negligible.
Among patients- responses for often use antibiotics were the maximum (54.5%), while that of
very often & sometimes were equal (18.2% each). But responses for never used were not
received. [Pie Chart 3]
Among pharmacists- responses for often use antibiotics were the maximum (52%), while that of
sometimes (27 %) and very often (12 %) were found. But responses for never before (9%) were
the least received among pharmacist. [Pie Chart 4]
54
Among doctors- responses for often use antibiotics were the maximum (50%), while that of very
often (30 %) & sometimes (20 %) were found. But responses for never used were not received
among doctors too. [Pie Chart 5]
Interpretation:
It can be inferred that the frequency of antibiotics usage has been increased among all the
sections of the society including chemists/pharmacists & doctors.
PATIENT AWARENESS – Further Analysis
Hypothesis 3: Effect of awareness among patients about side-effects & allergies of antibiotics
on their behaviour of referring a doctor before taking antibiotics.
Findings: [Table 3, 4, 5, 6 & 7]

 From Table 3, it can be inferred that out of those people who have used antibiotics in
their life, 60% have referred a doctor before taking antibiotics. While 40% of them had
taken antibiotics without consulting a doctor. [Bar Chart: 1]
 From Table 4, it is seen that 83.3% of patients who consulted a doctor knew the side-
effects caused by antibiotics & that explains why they referred doctor before consuming
antibiotics. While 16.7 % of them didn’t know that antibiotics cause side-effects but
referred a doctor before consuming antibiotics.
 But 25% of the patients who didn’t consulted doctor knew that antibiotics cause side-
effects, still they didn’t refer doctor before consuming antibiotics.
 While 75% of them didn’t know any side-effects of antibiotics and that can probably
explain the reason why they didn’t refer a doctor before taking antibiotics.
 From Table 5, it can be inferred that most of the people don’t consult a doctor before
taking antibiotics since it has highest mean value (2.000).
 From Table 6, it can said that there is no significant difference of means of knowledge
of side-effects of antibiotics in the referring to a doctor before taking antibiotics (p>0.05).
 From Table 7, it is observed that 66.7% of the patients who referred a doctor before
consuming antibiotics have some allergy from any antibiotics. 16.7 % of them didn’t
know if they have any or not, while rest 16.7% didn’t know that antibiotics can even
cause allergy.
 25% of the patients who didn’t refer a doctor have some kind of allergy from antibiotics;
still they didn’t consult a doctor before consuming antibiotics. 25% of them didn’t know
any allergies caused by antibiotics while rest 50% didn’t even know that antibiotics cause
allergy which probably explains the reason of their behaviour.
Interpretation:
 It can be inferred from the data that most of the people consuming antibiotics use them
without referring a doctor.
55
 In spite of knowing the side-effects of antibiotics, patients don’t consult doctors while
still a major part of population doesn’t know that antibiotics do cause side-effects.
 It can be inferred that wither are not aware of the fact that antibiotics can cause allergies
or even on knowing this, they don’t bother to consult doctor before consuming
antibiotics.
Hypothesis 4: The awareness among patients about correct practise to be followed in case of
antibiotics on their behaviour of referring a doctor before its consumption.
Findings: [Table 8]
 It is seen that out of people who think it’s correct to take antibiotics from a chemist
without doctor’s prescription, 60% referred a doctor before taking antibiotics while rest
40% didn’t. [Bar Chart: 2]
 Similar percentage is found among people who think it is not correct. Thus we can say
that 40% of people in spite of knowing that it is wrong took antibiotics without
consulting a doctor.
Findings: [Table 9]
 It can be inferred that out of those people who said that they always finish their course of
antibiotics, 66.7% knew that antibiotic resistant bacteria is likely to reoccur if patient
doesn’t complete his course of antibiotics. While 33.3% of them said that reoccurrence of
disease doesn’t depend on finishing of course, but still finished their course may be
following doctor’s instruction.
 Out of people who often finish their antibiotics course, 40% didn’t know about
reoccurrence of antibiotics resistant bacteria. While 60% of them said that reoccurrence
of disease doesn’t depend on finishing of course.
 Out of those who sometimes complete their antibiotics course, 50% knew about antibiotic
resistant bacteria being the reason of reoccurrence of disease. While rest 50% didn’t
know about bacteria, probably explaining the reason why they don’t finish their course of
antibiotics.
Interpretation:
 Most of the people think it is correct to take antibiotics from a chemist/pharmacist
without consulting a doctor whereas some in spite of knowing it is not correct take
antibiotics without referring a doctor.
 A major part of population is still unaware about antibiotic resistant bacteria & the fact
that disease reoccurs if a patients doesn’t complete his course of antibiotics.
 In spite of knowing that disease may reoccur is they don’t complete the course of
antibiotic, patients don’t bother to finish their antibiotic course.
56
EDUCATION AS A FACTOR OF SELF-MEDICATION
Hypothesis 5: To find whether education is a factor influencing behavior towards misuse & self-
medication of antibiotics.
Findings: [Table 10]
 It can be inferred from the table that out of the people whose highest level of education
was undergraduate, 100% didn’t refer a doctor before taking antibiotics.
 Out of people with highest education as graduation, 53.4% didn’t refer a doctor before
taking antibiotics.
 Out of post-graduated people, only 14.3% consumed antibiotics without consulting a
doctor.
 Out of people who have done doctorate, 87.5% didn’t refer a doctor before taking
antibiotics. Here the reason may be attributed as their own knowledge about medicines.
Interpretation:
 In can be said that low levels of education in M.P. State in India are one of the factors
leading to increasing trends of self-medication.
 This clearly explains the reason of their behavior & increasing cases of misuse of
antibiotics.
 But it’s surprising to know that some of well educated people also don’t refer a doctor
before consuming antibiotics. The reasons for this may b many, but still it is unsafe to use
antibiotics without doctor’s consultation as a disease may appear something else, but
actually might be something else.
PHARMACIST/CHEMIST RESPONSIVENESS
Hypothesis 6: The attitude of pharmacists/chemists towards self-administration of antibiotics.
Findings:
 Out of the responses received from the chemists/pharmacists, 88% have taken antibiotics
in their life, 8% haven’t while 4% didn’t know about it. [Table 11]
 40.9% among those who have taken antibiotics in their life have referred a doctor before
taking antibiotics while 59.1% didn’t consult one. [Table 12]
 58.3% of those who consume antibiotics very often don’t refer a doctor before taking
them while 59.1% of those who often take antibiotics don’t refer a doctor. 77.8% of those
consume only sometimes don’t refer a doctor. [Table 13]
57
Interpretation:
 It can be inferred that among the chemists/pharmacists, most of them have taken
antibiotics and more than half amongst them didn’t consult a doctor consuming them.
 Among the pharmacists, those who take antibiotics very often & often didn’t consult
doctor before consuming them.
 In this case, the reason can be stated as since they are dealing with medicines & have a
fair knowledge about them know the usage. But in the case of antibiotics, doctor’s
prescription is a necessity as they have many side-effects & may cause allergies.
Hypothesis 7: Sense of morality among chemists/pharmacists towards dispensing of antibiotics

without doctor’s prescription.
Findings:
 66% of chemists/pharmacists agree & 6% strongly agree that there should be a strict law
against dispensing antibiotics over the counter without checking doctor’s prescription
while 25% disagree & 3% strongly disagree with that. [Table 14]
 62.5% of the pharmacists/chemists who think it’s not fair on chemist’s part to dispense
antibiotics without doctor’s prescription provide antibiotics strictly on prescription only,
while 37.5% of those think it’s fair. [Table 15]
Interpretation:
 It can be observed that most of the chemists/pharmacists agree % believe that there
should be strict laws against dispensing of antibiotics without doctor’s prescription.
 Most of them who believe it’s not fair on chemist’s part to dispense antibiotics without
prescription provide antibiotics to patients only on prescription.
DOCTOR’S POINT OF VIEW
Hypothesis 8: To find out whether doctors advise their patients not to consume antibiotics
without referring a doctor & thus think its doctor’s or chemist’s duty to guide them.
Findings:
consulting a doctor, 70% think that it is doctor’s duty to give patients such advice. While
61.5% of those who often advise their patients think it is doctor’s duty. [Table 18]
58
consulting a doctor, 70% think that it is chemist’s duty to give patients antibiotics only on
doctor’s prescription. While 61.5% of those who often advise their patients think it is
chemist’s duty.[Table 19]
Interpretations:
 It can be inferred that most of the doctors who advise their patients about misuse of
antibiotics & that they should be consumed only after consulting a doctor think it is
doctor’s duty as well as chemist’s duty to advise patients. The chemist’s should
themselves not dispense antibiotics without a doctor’s prescription. The chemists should
also advise such patients coming to them for self-prescribed drugs to refer a doctor and
then only give them the drugs.
“From all the above it can be inferred that the practise of self-medication of antibiotics in
M.P. State, India is still prevalent & being followed.”
59
CHAPTER: 6 CONCLUSION, IMPLICATION & RECOMMENDATION
BENEFITS OF THIS RESEARCH
Proper practices being followed by chemists/pharmacists/druggists, as per the guidelines, ensure:

 Health of the people.
 No misuse of potent & hazardous drugs.
 No illegal activity performed.
 Helps stop anti-social activities.
 Public awareness.
Since this study involves people from all sections of the society in M.P. State, India, it helps:
 Understand the prevalence of the practise of self-medication of antibiotics properly.
 It helps understand the patients’ behaviour towards consumption of antibiotics.
 It also helps realize whether the chemists/pharmacists perform their jobs honestly and
follow the rules & guidelines or not.
 It enables the govt. authorities to realize the condition of self-medication.
 It helps doctor’s understand their patients’ tendency & their behaviour.
BENEFITS FOR THE STUDENTS
 To understand the Indian Pharmaceutical Market.
 To understand the factors that influence self-medication in M.P. State, India.

 To understand the influence of education & awareness among patients in self-medication.
 To get a glimpse of the patient perception.
 To understands the recent trends in the antibiotic market.
60
LIMITATIONS:
1. The reason behind patients’ perception towards antibiotics is difficult as it may include
various factors.
2. It may not be possible to cover the whole population so the sample size
selected maybe small.
3. Prone to
o Non response error
o Unconscious misinterpretation
o Deliberate falsification
o Acquiescence Bias
o Extremity Bias and
o Interviewer bias
o Respondents may not actively participate in the process of giving information.
RECOMMENDATIONS:
Antibiotics are potent drugs which cause side-effects and may cause allergy too. There are
various rules & norms laid down by the FDA which needs to be strictly followed.
For this to happen, I would recommend:
 Chemists/pharmacists/druggists need to understand their responsibilities & realize their
importance in the society.
 The doctors also need to be more assertive in making sure their patients don’t use the
once-prescribed again for similar kind of disorder either for themselves or for any other
person.
 The rules against selling of antibiotics without prescription need to be more vigilant.
 Though there have been issues about making some categories as OTC Drugs, still until
govt. takes any concerned step, it should not be permitted, rather completely prohibited.
 Proper database regarding sale of antibiotics should be maintained.
61
 Strict actions should be taken against such chemists.

 Some measure to educate population & make them aware regarding self-medication need
to be taken by the govt.
Some Recommendations/ Precautions For Patients/People:
 The patients need to understand that self-medication, especially in the case of antibiotics
can be hazardous as it causes side-effects & allergies too. Thus it is recommended to use
antibiotics only after consulting a doctor.
 The patients should realize that dispensing antibiotics over the counter without asking for
doctor’s prescription is illegal and not permitted by the govt. thus, even if they notice
some chemist performing such activity, they should inform concerned authority.
 The people should not follow such practices by themselves and should also guide others
regarding this.
CONCLUSION:
The research project helped me to study about the prevalence of practise of self-medication in
M.P. State, India. I came to realize the increasing need of assertive & solid measures to be taken
by the govt. soon to stop this misuse of drugs. I also understood the patients’ perceptions towards
antibiotics & their behaviour towards their administration.
The research projects enabled me to get a clear picture about the malpractices followed by the
chemists/pharmacists. It also helped me to understand some of the factors influencing the
practice of self-medication of antibiotics and their misuse.
I also realized the chemists’ behaviour & perception towards dispensing antibiotics as over the
counter without seeking the doctor’s prescription.
Thus, as a conclusion, it can be stated that there is an urgent to take some solid steps to stop this
practise of self-medication of may be hazardous antibiotics among the people of
M.P. State, India.
62
REFERENCES
WEBSITES & SOURCES
1. http://en.wikipedia.org/wiki/Health
2. http://en.wikipedia.org/wiki/Over-the-counter_drug
3. http://www.merck.com/mmhe/sec02/ch018/ch018a.html
4. http://en.wikipedia.org/wiki/Pharmacist
5. http://en.wikipedia.org/wiki/Antibiotic
6. http://en.wikipedia.org/wiki/Allergy
7. http://www.utdol.com/patients/content/topic.do?topicKey=~BGPByYTXv9Rb9I
8. http://www.sciencedaily.com/releases/2005/01/050111162856.htm
10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627681/pdf/10081668.pdf
12. http://jac.oxfordjournals.org/cgi/content/abstract/59/1/152
13. http://www.ncbi.nlm.nih.gov/pubmed/8218690
14. http://ijsa.rsmjournals.com/cgi/content/abstract/8/7/456
15. http://www.indianjmedsci.org/article.asp?
16. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-46FPT4
17. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-466KJ45
18. www.sciencedirect.com
19. www.spss.com
BIBLIOGRAPHY
 TRIPATHI, K.D., “Essentials of Medical Pharmacology”, 5th Edition, Jaypee

Publications, New Delhi.
 KOTHARI, C.R (1990), “Research Methodology methods and techniques”, New Delhi,
New Age International (p) Ltd.
 SA WAKSMAN (1947). "What Is an Antibiotic or an Antibiotic Substance?
 DAVIES, JULIAN, “Antibiotic Resistance: A Growing Health Threat, in Forum for
Applied Research and Public Policy.
63
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Research Report on Self-Medication of Antibiotics in M.P.

CHRIST UNIVERSITY INSTITUTE OF MANAGEMENT

A STUDY ON PREVALENCE OF THE Practise OF

1st yr, MBA (IB), CUIM

CERTIFICATE OF THE GUIDE

Name of Guide in charge, Signature of the Guide in charge,

Date: 27th April 2010

However, the important questions are”

“Is the practise of self-medication still prevalent in India?”

“Is this practice fair on the pharmacists’/chemists’/druggists’ part to dispense Antibiotics

KINSHOO SHAH, 1st yr, MBA (IB), CUIM

Action Plan Followed.........................................................................................................................31

CHAPTER: 6 CONCLUSION, IMPLICATION & RECOMMENDATION.................................59

LIST OF TABLES AND FIGURES

S. No List of Tables Page No. S. No List of Tables Page No.

1.1 Table 1 23 1.11 Table 11 45

1.2 Table 2 24 1.12 Table 12 45

1.3 Table 3 37 1.13 Table 13 46

1.4 Table 4 37 1.14 Table 14 47

1.5 Table 5 38 1.15 Table 15 48

1.6 Table 6 38 1.16 Table 16 49

1.7 Table 7 39 1.17 Table 17 50

1.8 Table 8 40 1.18 Table 18 51

1.9 Table 9 42 1.19 Table 19 52

S. No List of Pie Charts Page

“Mens sana in corpore sano”

A common saying about health:

“Health is not valued till sickness comes”.

OVER-THE-COUNTER (OTC) DRUGS are medicines that may be sold directly to a

In addition to the substances such as aspirin and acetaminophen that people typically think of as

Considerations in Reclassifying a Drug as Over-The-Counter: [Ref 3]

 Is the drug habit forming?

 Do the benefits of OTC status outweigh the risks?

Ease of Diagnosis & Treatment

 Can adequate directions for use be written?

 Can warnings against unsafe use be written?

 Can the average person understand the information on the label?

CHEMISTS & PHARMACISTS

Pharmacists are health professionals who practice the science of pharmacy. In their traditional

Roles & Responsibilities:

 Pharmacists/druggists/chemists act as a learned intermediary between physicians and

 Pharmacists/druggists/chemists also participate in disease-state management, where they

 Decreased medication errors

Few antibiotics: Penicillin, Cephalosporins, Macrolides, Quinolones, Carbapenems, and Other

Few manufactures of Antibiotics: Abbott Laboratories, Advancis Pharmaceutical Corp., Bayer

Adverse effects may include:

“Did God who gave us flowers and trees,

Allergy is a disorder of the immune system often also referred to as atopy. Allergic reactions

 Swelling of your lips, face, or tongue

“Every patient carries her or his own doctor inside”.

A major shortfall of self-medication is the lack of clinical evaluation of the condition by a

Factors That Influence the Tendency of Self-Medication

 Changed regulation from Prescription-Only Medicine (POM) to Pharmacy (P) medicine

However, the important questions are”

“Is this practice of self-medication still prevalent in India?”

“Is this practice fair on the chemists’/druggists’/pharmacists’ part?”

The Objective of this research is to study the prevalence of practise of self-medication of

The Scope of this research includes:

 Analyzing the current scenario.

The Limitations of this research includes:

 Responses may be subjected to bias.

CHAPTER 2: LITERATURE REVIEW

~ ScienceDaily (Jan. 18, 2005)

STUDIES EXPLORING ANTIBIOTIC MISUSE