International Journal of Clinical Pharmacy

, Volume 39, Issue 3, pp 507–513 | Cite as

Self-medication with antibiotics in Serbian households: a case for action?

  • Ana Tomas
  • Milica Paut KusturicaEmail author
  • Zdenko Tomić
  • Olga Horvat
  • Daniela Djurović Koprivica
  • Dragica Bukumirić
  • Ana Sabo
Research Article


Background Irregular antibiotic use, including self-medication contributes to the development of antibiotic resistance. One method of accessing antibiotic use in the community is through obtaining an in house inventory of drugs. Objective The aim of this study was to investigate the extent of storage and self-medication with antibiotics agents in households in Novi Sad, Serbia. Setting Households in Novi Sad. Method The study was performed during a 4-month period (October 2015–January 2016) using a sample of 112 households in Novi Sad, Serbia. Two trained interviewers performed the survey by visiting each household. The study consisted of making an inventory of all drugs in household and a semi-structured interview about drug use practices and perceptions. Main outcome measure Number of antibiotics obtained without prescription. Results Out of 112 surveyed households, antibiotics were encountered in 55 (49.1%). Antibiotics constituted 11.98% (92/768) of total number of drug items in households. Out of all antibiotics in households, 41 (44.57%) were not in current use, and presented left-overs from previous treatment. Antibiotics were usually acquired with prescription (67, 67.7%), while about a quarter of packages were used for self-medication—purchased at pharmacy without prescription (19, 20.65%) or obtained through friends or family member (6, 6.52%).The most commonly used antibiotics for self-medication was amoxicillin (reported indications included common cold, cough, pharyngitis and tooth-ache). Conclusion Antibiotics were present in large share of households in Novi Sad. Self-medication with antibiotics and sale of antibiotics without prescription represent an important problem in Serbia.


Antibiotics Compliance Drug leftovers Home pharmacies Home remedies Households Self-medication Serbia 



We would like to thank all study participants involved in this research for giving up their time to take part in the study.


This work was supported by the Ministry of Science and Technological development, Republic of Serbia, Project No. 41012.

Conflicts of interest

The authors of this manuscript have no conflicts of interest to declare.

Supplementary material

11096_2017_461_MOESM_ESM.pdf (241 kb)
Supplementary material 1 (PDF 242 kb)


  1. 1.
    De Kraker ME, Jarlier V, Monen JC, Heuer OE, Van De Sande N, Grundmann H. The changing epidemiology of bacteraemias in Europe: trends from the European Antimicrobial Resistance Surveillance System. Clin Microbiol Infect. 2013;19(9):860–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Goossens H, Ferech M, Vander Stichele R, Elseviers M, ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365(9459):579–873.CrossRefPubMedGoogle Scholar
  3. 3.
    Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev. 2010;74(3):417–33.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe 2014. Annual report of the European Antimicrobial Resistance Surveillance Network [EARS-Net]. ECDC, Stockholm; 2015.Google Scholar
  5. 5.
    Bbosa GS, Mwebaza N. Global irrational antibiotics/antibacterial drugs use: a current and future health and environmental consequences. Microb Pathog Strateg Combat Them Sci Technol Educ. 2013;4(3):1645–55.Google Scholar
  6. 6.
    Paut Kusturica M, Tomić Z, Bukmirić Z, Horvat O, Pavlović N, Mikov M. Antibiotics in Serbian households: a source of potential health and enviromental threats. Cent Eur J Public Health. 2015;23(2):114–8.CrossRefGoogle Scholar
  7. 7.
    Kusturica MP, Tomic Z, Bukumiric Z, Ninkovic L, Tomas A, Stilinovic N, et al. Home pharmacies in Serbia: an insight into self-medication practice. Int J Clin Pharm. 2015;37(2):373–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Cars O, Mölstad S, Melander A. Variation in antibiotic use in the European Union. Lancet. 2001;357:1851–3.CrossRefPubMedGoogle Scholar
  9. 9.
    Grigoryan L, Monnet DL, Haaijer-Ruskamp FM, Bonten MJ, Lundborg S, Verheij TJ. Self-medication with antibiotics in Europe: a case for action. Curr Drug Saf. 2010;5(4):329–32.CrossRefPubMedGoogle Scholar
  10. 10.
    Versporten A, Bolokhovets G, Ghazaryan L, Abilova V, Pyshnik G, Spasojevic T, et al. Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet. 2014;14(5):381–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Larson E, Lin XS, Gomez-Duarte C. Antibiotic use in hispanic households, New York City. Emerg Infect Dis. 2003;9(9):1096–102.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    González J, Orero A, Prieto J. Storage of antibiotics in Spanish households. Rev Esp Quimioter. 2006;19(3):275–85.PubMedGoogle Scholar
  13. 13.
    WHO. Introduction to drug utilization research. Oslo: WHO; 2003.Google Scholar
  14. 14.
    Orero A, Gonzalez J, Prieto J. Antibióticos en los hogares españoles. Implicaciones médicas y socioeconómicas [Antibiotics in Spanish households. Medical and socioeconomic implications. URANO Study Group]. Med Clin (Barc) 1997;109:782–5. (in Spanish).Google Scholar
  15. 15.
    Ngokwey N. Home remedies and doctor’s remedies in Feira (Brasil). Soc Sci Med. 1995;40:1141–53.CrossRefPubMedGoogle Scholar
  16. 16.
    Stratchounski LS, Andreeva IV, Ratchina SA, Galkin DV, Petrotchenkova NA, Demin AA, et al. The inventory of antibiotics in Russian home medicine cabinets. Clin Infect Dis. 2003;37(4):498–505.CrossRefPubMedGoogle Scholar
  17. 17.
    Sawalha A. Extent of storage and wastage of antibacterial agents in Palestinian households. Pharm World Sci. 2010;32(4):530–5.CrossRefPubMedGoogle Scholar
  18. 18.
    WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment 2013. Oslo; 2012. Accessed 14 Dec 2016.
  19. 19.
    De Bolle L, Mehuys E, Adriaens E, Remon JP, Van Bortel L, Christiaens T. Home medication cabinets and self-medication: a source of potential health threats? Ann Pharmacother. 2008;42(4):572–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Wondimu A, Molla F, Demeke B, Eticha T, Assen A, et al. Household storage of medicines and associated factors in Tigray Region, Northern Ethiopia. PLoS ONE. 2015;10(8):e0135650.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Aljinovic-Vucic V, Trkulja V, Lackovic Z. Content of home pharmacy and self-medication practices in households of pharmacy and medical students in Zagreb, Croatia: findings in 2001 with a reference to 1977. Croat Med J. 2005;46(1):74–80.PubMedGoogle Scholar
  22. 22.
    Grigoryan L, Haaijer-Rysjamp FM, Burgerhof JG, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12:452–9.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Ceaser S, Wurtz R. Leftover antibiotics in the medicine cabine. Ann Intern Med. 2000;133:74.CrossRefPubMedGoogle Scholar
  24. 24.
    Richman P, Garra G, Eskin B, Nashed A, Cody R. Oral antibiotic use without consulting a physician: a survey of ED patient. Am J Emerg Med. 2001;19:57–60.CrossRefPubMedGoogle Scholar
  25. 25.
    Bennadi D. Self-medication: a current challenge. J Basic Clin Pharm. 2014;5(1):19–23.CrossRefGoogle Scholar
  26. 26.
    Väänänen MH, Pietilä K, Airaksinen M. Self-medication with antibiotics-does it really happen in Europe? Health Policy. 2006;77(2):166–71.CrossRefPubMedGoogle Scholar
  27. 27.
    Matuz M, Benko R, Doro P, Hajdu E, Soos G. Non-prescription antibiotic use in Hungary. Pharm World Sci. 2007;29:695–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Saradamma RD, Higginbotham N, Nichter M. Social factors influencing the acquisition of antibiotics without prescription in Kerala State, south India. Soc Sci Med. 2000;50(6):891–903.CrossRefPubMedGoogle Scholar
  29. 29.
    Jakovljevic M. Resource allocation strategies in Southeastern European health policy. Eur J Health Econ. 2013;14:153–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Vukmirovic S. Farmakoepidemiološki i farmakoterapijski aspekti upotrebe antibakterijskih lekova–usklađenost nacionalnih vodiča i lokalne rezistencije bakterija [Pharmacoepidemiological and pharmacotherapeutic aspects of antibacterial use—adherence to National guidelines and local resistance patterns] [dissertation]. Novi Sad (Serbia): Medical faculty of Novi Sad; 2013.Google Scholar
  31. 31.
    Morgan DJ, Okeke NI, Laxminarayan R, Perencevich NE, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. Lancet Infect Dis. 2011;11:692–701.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Grigoryan L, Burgerhof J, Haaijer-Ruskamp F, Degener J, Deschepper R, Monnet D, et al. Is self-medication with antibiotics in Europe driven by prescribed use? J Antimicrob Chemother. 2007;59(1):152–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Ana Tomas
    • 1
  • Milica Paut Kusturica
    • 1
    Email author
  • Zdenko Tomić
    • 1
  • Olga Horvat
    • 1
  • Daniela Djurović Koprivica
    • 2
  • Dragica Bukumirić
    • 3
  • Ana Sabo
    • 1
  1. 1.Department of Pharmacology Toxicology and Clinical Pharmacology, Faculty of Medicine Novi SadUniversity of Novi SadNovi SadSerbia
  2. 2.Department of Dentistry, Faculty of Medicine Novi SadUniversity of Novi SadNovi SadSerbia
  3. 3.Department of Planning, Analysing and StatisticsPrimary Healthcare CenterPančevoSerbia

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