Prevalence and risk of antibiotic self-medication and unexpected determinants among patients admitted to the emergency department in a resource-limited setting: a cross-sectional study

Background The overuse of antibiotics without a medical prescription has a major consequence: the development of bacterial resistance, which can lead to incurable invasive infections and increase global mortality. This study aims to determine the prevalence of self-medication and identify the main risk factors associated with antibiotic self-medication. Methods This cross-sectional, descriptive, and analytical study over a five-month period among all patients aged 18 years and older admitted to the emergency department. We collected sociodemographic data, data on self-medication practices, and data on access to care. Multivariate logistic regression was applied to identify independent factors associated with antibiotic self-medication. Results The prevalence of antibiotic self-medication was very high at 77.7% in our study. The study revealed that amoxicillin (38.3%) and metronidazole (27.6%) were the most frequently used drugs, followed by penicillin V (19.0%) and chloramphenicol (17.1%). Several factors were predictive of antibiotic self-medication, including: Age (subjects aged 55 to 64; OR = 6.98, p = 0.006 and in subjects aged 65 and over; OR = 43.36, p = 0.002); Self-employed individuals were 38.0% more likely to engage in self-medication compared to employees (OR = 1.38, 95% CI: 0.86, 2.22, p = 0.184). Monthly income was significantly associated with self-medication (χ² = 29.0, p < 0.001), with the highest prevalence observed among individuals earning 200,001–300,000 ME (16.6%). Conclusion The study highlights significant trends in antibacterial self-medication, highlighting the influence of demographic and socioeconomic factors. These results suggest the need for targeted public health interventions, particularly among older populations.