# Prevalence of Over-the-counter use of Antibiotics among Patients visiting Outpatient Department of a Primary Health Centre: An Observational Study

## TL;DR

This study found that about 23% of patients at a Nepal primary health center used antibiotics without a prescription, with amoxicillin plus clavulanic acid being the most common.

## Contribution

The study provides new data on antibiotic over-the-counter use prevalence in Nepal's primary health centers.

## Key findings

- 22.81% of 377 participants used over-the-counter antibiotics.
- Amoxicillin plus clavulanic acid was the most commonly used antibiotic.
- Respiratory symptoms were the most common reason for antibiotic use.

## Abstract

Antimicrobials are the most commonly used medicine. Over-the-counter
use of antibiotics is more prevalent in developing countries, contributing to inappropriate use and increasing antimicrobial resistance. Studies regarding over the counter use of antibiotics are lacking in Nepal. The objective of this study was to determine prevalence of over the counter use of antibiotics among patients visiting primary health centre.

A descriptive cross-sectional study was conducted among 377 participants from October 2024 to February 2025 at Outpatient department of Melamchi Primary Health Centre after obtaining ethical approval from the Ethical Review Board of Nepal Health Research Centre (Reference no: 820). Written informed consent was obtained and prevalence of over-the-counter use of antibiotics was examined using a structured proforma. Data was entered into Microsoft Excel, and descriptive statistics were calculated.

Among 377 participants, 86 (22.81%) were using over-the-counter antibiotics, of which 45 (52.32%) were male and 41 (47.67%) were female. 40 (46.51%) of those participants using over-the-counter antibiotics were older than 15 years, whereas 3 (3.48%) were less than 1 year of age. The most common presenting symptoms in these patients were related to the respiratory system 39 (45.34%). The most commonly used antibiotic was Amoxicillin plus clavulanic acid; 32 (37.20%).

The study reported a lower prevalence of over-the-counter use of antibiotics among patients presenting to primary health centers compared to the ‘WHO South-East Asia Region’.