MOUNT KENYA UNIVERSITY

SCHOOL OF MEDICINE

MUGUNI BRANDAN SIVITALI

BMS/2021/81368

A research proposal submitted to the School of Medicine in partial fulfilment of

the requirements for the award of the degree of Bachelor of Medicine and
Bachelor of Surgery of the Mount Kenya University.

RESEARCH TITLE:

KNOWLEDGE, ATTITUDES AND PRACTICES OF SELF MEDICATION

WITH ANTIBIOTICS AMONG STUDENTS OF MOUNT KENYA
UNIVERSITY.

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 DECLARATION

I, the undersigned, hereby declare the following

The work contained herein is original and has been done under the general supervision of the
undersigned supervisor.

This work has not been submitted to this institution for the award of a degree before.

The guidelines provided for by the university in developing research project proposals have been duly
followed

Whenever the contribution of others has been involved, every effort has been made to indicate them
clearly in the text in respect of various references and quotations.

Signature: ___________________________ Date: _____________________

MUGUNI BRANDAN SIVITALI

BMS/2022/81368

This research project proposal has been submitted with my approval as the university supervisor.

Signature: ___ Date: ____________

Dr. SHWETHA VIJAYAN

DEPARTMENT OF HUMAN PHYSIOLOGY M.K.U

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Table of Contents
DECLARATION............................................................................................................................................ii
LIST OF ABBREVIATIONS.......................................................................................................................iii
ABSTRACT...................................................................................................................................................iv
1.0 CHAPTER ONE: INTRODUCTION.....................................................................................................1
1.1 BACKGROUND INFORMATION........................................................................................................1
1.2 STATEMENT OF THE PROBLEM......................................................................................................2
1.3 JUSTIFICATION....................................................................................................................................2
1.4 RESEARCH QUESTION........................................................................................................................2
1.5 RESEARCH OBJECTIVES....................................................................................................................2
1.5.1 Broad objective......................................................................................................................................2
1.5.2 Specific objectives..................................................................................................................................2
1.6 CONCEPTUAL FRAMEWORK...........................................................................................................4
2.0 CHAPTER TWO: LITERATURE REVIEW........................................................................................5
2.1 Causes associated with antibiotic self – medication...............................................................................5
2.2 Level of knowledge of antibiotic self- medicating students...................................................................5
2.3 Attitudes of antibiotic self- medication...................................................................................................6
2.4 Practices associated with antibiotic self- medication.............................................................................6
3.0 CHAPTER 3: MATERIALS AND METHODS....................................................................................8
3.1STUDY DESIGN.......................................................................................................................................8
3.2STUDY AREA...........................................................................................................................................8
3.3TARGET POPULATION........................................................................................................................8
3.4 STUDY POPULATION...........................................................................................................................8
3.5 INCLUSION/EXCLUSION CRITERIA................................................................................................8
3.5.1 Inclusion criteria...................................................................................................................................8
3.5.2 Exclusion criteria..................................................................................................................................8
3.6 VARIABLES............................................................................................................................................8
3.6.1Independent............................................................................................................................................8
3.6.2 Dependent..............................................................................................................................................8
3.7 SAMPLING PROCEDURE....................................................................................................................8

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3.8 SAMPLE SIZE DETERMINATION.....................................................................................................9
3.9 SAMPLING TECHNIQUE.....................................................................................................................9
3.10 DATA COLLECTION...........................................................................................................................9
3.11 DATA MANAGEMENT.......................................................................................................................9
3.12 ETHICAL CONSIDERATION...........................................................................................................10
3.13 REFERENCE.......................................................................................................................................10
3.14 APPENDICES......................................................................................................................................18
3.14.1 WORK PLAN....................................................................................................................................18
3.14.2BUDGET.............................................................................................................................................18
3.14.3CONSENT FORM.............................................................................................................................19
3.14.4 QUESTIONAIRE..............................................................................................................................19

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 LIST OF ABBREVIATIONS
M.K.U- Mount Kenya University.

COHES- College of health sciences

AMR- Antimicrobial resistance

MS - Microsoft

SPSS – Statistical Package for Social Sciences

CDC- Center for disease control

GIT- Gastrointestinal system

RTI- Respiratory tract infection

IV- Intravenous

UTI- Urinary tract infection

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 ABSTRACT
Antibiotic self-medication is defined as the selection and use of non-prescription antibiotics by an
individuals’ own initiatives to treat self-recognized illnesses or symptoms. Self -medication is a
global- phenomena with antibiotic self-medication becoming widespread with one of the greatest risks
being antimicrobial resistance. However, it has being reported that this risk has being gradually rising
as the use of over the counter medication in developing countries is becoming more frequent. This
study therefore seeks to determine the knowledge, attitude and practices associated with antibiotic
self- medication among Mount Kenya University students. The study will employ a descriptive cross-
sectional study, with data being collected at a single point in time and assessing the population as
represented by the study sample at a single point in time. The study population will be sampled by
simple random sampling. Data will be primarily collected by use of interviewer administered semi-
structured questionnaires to subjects who will meet the inclusion criteria. Data will then be entered
into the MS Access database with inbuilt consistency and validation checks. Analysis will be done
using the SPSS analytical package. Presentation will be in form of tables and graphs.

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1.0 CHAPTER ONE: INTRODUCTION
1.1 BACKGROUND INFORMATION
Self-medication is defined as the selection and use of non-prescription medicines by individuals’ own
initiatives to treat self-recognized illnesses or symptoms. It is also obtaining and consuming
medication without professional supervision regarding indication, dosage, and duration of treatment
(Gutema et al., 2011).

Self-medication is a global phenomenon that most individuals practice throughout their daily life. The
world health organization reports that self-medication with antibiotics is becoming widespread with
one of the greatest risks being antibiotic resistance through limiting uptake of drug, modifying drug
target, inactivating a drug and active efflux. It has been reported that this risk has being gradually
rising as the use of over-the-counter medication in developing countries is becoming more
unregulated hence becoming more frequent due to accessibility to the drugs, poor polices on drug
control, under qualified practitioners, cultural customs and a perceived saving of time and money
compared to see a doctor. (Ali, et al., 2016).

Antibiotics are considered as one of the greatest inventions of the 20th century by Alexander flaming
who discovered penicillin which greatly contributed to decreased morbidity and mortality in many
infectious diseases. Improvements in knowledge levels, socioeconomic status and education may
provide the foundation for successful self-medication. However, inappropriate self-medication wastes
resources, increases the likelihood of adverse drug reactions and may also be involved in
antimicrobial resistance. (James H, et al.,2006).

Antibiotic resistance is one of the world’s most pressing public health problems. We are at the dawn
of a post-antibiotic era (CDC 2013). This resistance may result in longer-lasting illnesses, more
hospital stays, the need for more expensive and toxic medications, and even death (Holmberg et al.
1987; Davies 1994; Magee et al. 1999; Fischbach & Evans 2007).

Inappropriate use of antibiotics may contribute to the emergence of antibiotic resistance

(Apisarnthanarak et al.2008; Goossens 2009). Self-medication with antibiotics, in which antibiotics
are used without medical consultation, can easily lead to their inappropriate use (Jose et al.2013), yet
this practice is highly prevalent in developing countries with lax regulatory systems (Borg & Scicluna
2002; Morgan et al. 2011; Laxminarayan & Heymann2012). Sstudent’s occupy a unique position in
the niche of propagating self-medication; it is Ilegal to prescribe medications but as they progress
through their education level and access to internet services, they may acquire greater knowledge
about medicines and be more capable regarding their rational use. Self-medication is more likely
among students as they have easy access to drug information sources.). They also have easier access
to medicines both through chemistry purchasing, previous friends’ medication, over the counter
drugs, forged prescription and poor drug regulatory polices by government.

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1.2 STATEMENT OF THE PROBLEM
Inadequate knowledge of medication use may directly lead to misuse by community and/or patients,
noncompliance with a drug regimen and results in serious outcomes like adverse drug reaction and
reduction of the quality of treatment. It is also thought that there is not enough attention focused on
the use of antibiotics. Moreover, health personnel and the community have insufficient information
about the adverse consequences, resulting from improper antibiotic use. (Celik, S. et al., 2010).
Antibiotic resistance has recently become an increasing problem worldwide due antibiotic abuse or
overuse. (Agarwal, S. et al., 2015). Furthermore, inappropriate antibiotic use may increase the
incidence of adverse, including allergic reactions, and may lead to negative results, such as
unrecoverable financial burden. (Ayalew, M. B, et al., 2017 and Fredricks, I. et al., 2017). At an
individual level, knowledge and beliefs affect health-related behavior, including behavior concerning
antibiotics use (Sawalha 2008; Widayati et al. 2011). Misconceptions about antibiotics among
students potentially cause antibiotic abuse. This subject remains understudied in Kenya and hence
presents a knowledge gap.

1.3 JUSTIFICATION
Given that abuse of antibiotics in undergraduate students in learning institutions continues to be a
significant problem in both developed and developing countries (Zafar et al. 2008), reducing
misconceptions regarding antibiotic use among this population is imperative. The results of this study
will provide epidemiological information that will serve as an essential input for policy makers to
design proper strategies to address antibiotic self -medication. Moreover, knowledge of the local self-
medication patterns and outcomes may raise the index of suspicion, for antimicrobial resistant bugs
and reduce morbidity and mortality. The study will bridge the gap in knowledge in this given subject
and also serve as future references for those who want to undertake research on the level of
knowledge, practices and attitude of antibiotic self -medication in Kenya and other countries

1.4 RESEARCH QUESTION

i. What are the causes associated with antibiotic self-medication among Mount Kenyatta
University students?
ii. What is the knowledge of students self-medicating with antibiotics at Mount Kenyatta
University?
iii. What are the attitudes and beliefs of self- medicating among Mount Kenyatta University
students?
iv. What are the practices associated with antibiotic self-medication among Mount Kenyatta
University students?
1.5 RESEARCH OBJECTIVES
1.5.1 Broad objective.
To assess the knowledge, attitude and practices of self - medication with antibiotics among Mount
Kenya University students.

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1.5.2 Specific objectives.
i. To assess causes associated with antibiotic self- medication among Mount Kenya University
students.
ii. To assess the level of knowledge of antibiotic self- medication among Mount Kenya
University students.
iii. To determine the attitude and beliefs of antibiotic self- medication among Mount Kenya
University students.
iv. To determine practices associated with antibiotic self-medication among Mount Kenya
University students.

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1.6 CONCEPTUAL FRAMEWORK
INDEPENDENT VARIABLES
DEPENDENT VARIABLES

Causes of antibiotic self-

medication.

Gastrointestinal, respiratory
and UTIs

Level of knowledge of
antibiotic self -medicating
students. Self- medication with
antibiotics.

Antibiotic adverse reactions.

Antimicrobial resistance.

Attitude & Practices of

self- medicating
students.

Positive or negative
attitude on antibiotic
misuse

Underdoing, overdosing
and antibiotic misuse

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2.0 CHAPTER TWO: LITERATURE REVIEW
2.1 Causes associated with antibiotic self – medication.
According to a study at Ahmadu Bello university the major reasons given for antibiotic self-
medication included assumed knowledge on antibiotics (34.98%), prior experience on use (28.27%),
lack of time to go for consultation (14.49%) and the attitude of the school sickbay staff (14.49%).
Only 11.31% reported that the nature of the illnesses was not serious enough for consultation.
Majority of the students 238 (84.10%) reported that they self- medicated for gastrointestinal infections
(GIT), 119 (42.08%) for genitourinary infections, 49 (17.30%) and 43 (15.15%) for respiratory tract
infections (RTI) and skin infections respectively. (O.J. Olayemi, B.O. Olayinka and A.I. Musa., et al
2010).

In another study it was identified that 31.1% started using antibiotics on their own. The reasons for
starting use being; flu 62.1%, sore throat 41.2%, toothache/ swelling 23.7%, headache 18.1% fever
16.9% cough 15.8%, abdominal pain 13.0%, weakness 10.7%, urinary burning 7.3% and skin
infection 6.2%. (Sergul Donmez, et al., 2018). In the same study 22.6% of antibiotic self- medicating
students did not have time to visit a doctor. 16.9% of those using antibiotics were advised by close
friends and relatives. (Sergul Donmez, et al., 2018).

2.2 Level of knowledge of antibiotic self- medicating students.

According to a study done in the United Arab Emirates on 600 medical students evaluating
knowledge on antibiotic use, the level of knowledge was reported at 59% which is relatively low.
35.2% (N=212) of the medical students responded that antibiotics can be used to cure viral infections
and 65.2% believed antibiotics could speed up recovery from colds, coughs and diseases.
Additionally, 84.5% of medical students surveyed reported to have heard about antibiotic resistance.
However, 71.8% of these respondents could not accurately define antibiotic susceptibility (Jairoun et
al., 2019).

In 2019, 536 students from a school in Medellin, Colombia composed of about two thirds’ females
43.5% of the students considered that the university had not sufficiently prepared them to interpret
anti-biograms. Furthermore, close to half of the respondents considered that they had received
insufficient clinical training with regard to switching from intravenous (IV) to oral antibiotics, and
21.4% of the students considered themselves inadequately trained to find reliable sources of
information. Typically, 29.6% of the students considered that the quality of information received on
the subject at their university ranged from regular to poor which poses a significant gap for these
students to discharge their responsibilities (Higuita-Gutiérrez et al., 2020).

A study carried out in Rwanda in 2019 evaluating the knowledge of 228 students reported satisfactory
knowledge scores on antibiotic use and antibiotic resistance. 95% of the respondents revealed that
unnecessary use of antibiotics drives antibiotic resistance and 96% reported to have heard about
antibiotics resistance. Moreover, 49% of the students acquired antibiotics from private pharmacies or
hospitals without a prescription and 83% revealed that they never heard about antibiotic stewardship.

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Despite their good knowledge lack of awareness on antibiotic stewardship dents proper antibiotic use
(Nisabwe et al., 2020).

In another study carried out in Nigeria in the first half of 2019, with to two-thirds of the respondents
(62.5%) being males, 126 (68.5%) aged between 25–29 years and about being 60.9% (112) in their
final year of undergraduate studies, 96.2% respondents correctly linked indiscriminate use of
antimicrobial drugs to the development of antimicrobial resistance. Worryingly, 39.1% of the
students did not know that common cold and influenza are caused by viruses and do not warrant the
use of antibiotics. Most (98.4%) of the respondents knew that antimicrobial resistance was an
important global public health issue and 87.0% of them wanted more education on antimicrobial use
and resistance (Alex, 2019)

From the above studies the general knowledge on antibiotic use is very low. This hinders the proper
use and prescribing of antibiotics and may play a significant role in driving the rates of antimicrobial
resistance.

2.3 Attitudes of antibiotic self- medication

There are a number of studies that have been done evaluating attitude scores related to the use of
antibiotics and the development of micro-organisms that are insensitive to antibiotic drugs. For
example, significant proportion of the participants in a study carried at the University of Split in
Croatia reported that antimicrobials are overused (90.7%). Keeping a stock of antibiotics at home
was a reported behavior a practice commonly seen among participants who have a family member
working in a health -related field (58.5% vs. 25.0%, p < 0.001). There was no difference in average
knowledge score among medical, MSE, or pharmacy students (p = 0.416). Students who achieved
higher knowledge score were more likely to rate their education about antimicrobial use and
resistance as very useful in combating this atrocious impending epidemic (Rosic et al., 2018).

Similarly, a survey subjected to students in Zambia evaluated students’ attitudes on the abuse of
antibiotics becoming the main cause of bacterial resistance, need for more education on antibiotics
and the need for carrying out large scale antibiotics campaign promotion to promote their rational use.
Results from this study revealed that majority of the participants 252 of 260 (96.9%) exhibited a
positive attitude and only 8 of 260 (3.1%) had a poor attitude score on antibiotic resistance (Zulu et
al., 2020)

2.4 Practices associated with antibiotic self- medication

In a study done in Nepal in 2018 evaluating the practices of antibiotic use among 252 students, 5.7%
of the students saved their antibiotics for future use when they feel ill. A further 16.2 % of students
sometimes consulted the doctor before starting an antibiotic dose and only 5.7% of students gave their
antibiotics to their friends and family members when they get sick (Shrestha, et al., 2019).

In 2019, a follow up survey evaluated the practices of 609 medical students on consulting a doctor
before starting an antibiotic, buying antibiotics from drug stores/pharmacies directly, using antibiotics
after suggestions from friends/neighbor and stopping to take a complete dose of antibiotics once
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symptoms of infection abate. The practice level of the first-year students and last-year students could
be described in two groups. First-year students showed a lower practice level than final-year students.
This therefore showed that drug knowledge was a positive predictor of the use of antibiotics among
medical students (Shah et al., 2019).

From the above studies the general knowledge, attitudes and practices related to the use antibiotic use
is very low. This hinders the proper use and prescribing of antibiotics and may play a significant role
in driving the rates of antimicrobial resistance. Therefore, it sounds sensible to lay down strategies
that preserve the current pool of antibiotics. Globally a number of studies have shown that appropriate
use of antibiotics decreases the risk of antimicrobial resistance and these practices can be translated to
Kenyan settings (Llor & Bjerrum, 2014). This study therefore aimed to evaluate the baseline
knowledge, attitudes and practices related to antibiotic use and resistance among students in Mount
Kenya University. Information accrued from this study might be important in shaping education
interventions in Kenya.

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3.0 CHAPTER 3: MATERIALS AND METHODS
3.1STUDY DESIGN
This will be a descriptive cross-sectional study.

3.2STUDY AREA
Mount Kenya University located in Kenya, Kiambu County, Thika constituency in Thika town. It is a
private university with a college of health sciences that oversees the graduation of about 600 medical
students every year. They are students in various medical specialties including medicine, pharmacy,
nursing, medical laboratory science as well as public health.

3.3TARGET POPULATION
Mount Kenya University students

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3.4 STUDY POPULATION
3.5 INCLUSION/EXCLUSION CRITERIA
3.5.1 Inclusion criteria
All Mount Kenya University students including College of health sciences students taking a
bachelor’s degree in Pharmacy, MBChB, Clinical medicine, Nursing, Physiotherapy and Public health
and other courses offered within the institution.

3.5.2 Exclusion criteria

The project will exclude all students who do not give their consent. This means that no student will be
coerced to fill out the questionnaire presented for data collection.

3.6 VARIABLES
3.6.1Independent.
Causes of antibiotic self-medication such as Gastrointestinal, respiratory and UTIs.

Level of knowledge of antibiotic self -medicating students.

Attitude & Practices of self- medicating students. Such as Positive or negative attitude on antibiotic
misuse or Underdoing, overdosing and antibiotic misuse

3.6.2 Dependent.
Self- medication with antibiotics.

Antibiotic adverse reactions.

Antimicrobial resistance.

3.7 SAMPLING PROCEDURE.

Random sampling.

3.8 SAMPLE SIZE DETERMINATION.

The prevalence of antibiotic use among university students in Kenya is not known. Hence, in my
calculation, I will use a 50% prevalence rate to determine sample size with a confidence interval of
95%.

n = Z² x P (1-P)

d2

Where; P= 50%, d= 5%, Z= 1.96

= 1.96² x 0.5(1 - 0.5)

(0.05) ²

= 385 students

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Since the target population will be less than 10,000, the sample size will be adjusted based on the
number of students at Mount Kenya University.

nf = n

(1+n/N)

= 385

1.266

= 304 students

3.9 SAMPLING TECHNIQUE

Purposive sampling technique will be used in choosing students that will participate in this study

3.10 DATA COLLECTION

A self-administered questionnaire through Google will be sent electronically via Whats App as well
as a physical questionnaire, to students who met the inclusion criteria to assess the knowledge and
practices of antibiotic use. Data collection will be anonymous, in that Google forms as well as the
physical questionnaire will not reveal the identity of the student who filled the questionnaires to the
researcher.

3.11 DATA MANAGEMENT.

The process of data analysis will involve; check the data collected for errors and completeness,
organize and quantitatively analyze it. Data will be entered into Microsoft excel database and will be
analyzed using the computer package SPSS version 20. Descriptive analysis will be used to analyze
the qualitative variables while quantitative variables will be summarized using mean ± Standard
Deviation (±SD). A Chi-square test will be used to compare differences in the proportions of
qualitative variables.

3.12 ETHICAL CONSIDERATION 

Ethical approval for the study is to be obtained from Mount Kenya University Ethics and Research
Committee. Participants will have to read and understand the informed consent before participating
voluntarily in the survey. Confidentiality will be highly maintained.

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37. Oh, A. L., Hassali, M. A., Al-Haddad, M. S., Sulaiman, S. A. S., Shafie, A.

A., & Awaisu, A. (2011). Public knowledge and attitudes towards antibiotic

usage: A cross-sectional study among the general public in the state of

Penang, Malaysia. Journal of Infection in Developing Countries.

https://doi.org/10.3855/jidc.1502

38. S., P., T., N., G., M., Savkar, M., & M., R. (2016). Knowledge, attitude and

practices of antibiotic usage among the medical undergraduates of a tertiary

care teaching hospital: an observational cross-sectional study. International

Journal of Basic and Clinical Pharmacology. https://doi.org/10.18203/2319-

2003.ijbcp20164100

39. Struzycka, I., Mazinska, B., Bachanek, T., Boltacz-Rzepkowska, E., Drozdzik,

A., Kaczmarek, U., Kochanska, B., Mielczarek, A., Pytko-Polonczyk, J.,

Surdacka, A., Tanasiewicz, M., Waszkiel, D., & Hryniewicz, W. (2019).

Knowledge of antibiotics and antimicrobial resistance amongst final year dental

students of Polish medical schools—A cross-sectional study. European Journal

of Dental Education. https://doi.org/10.1111/eje.12430

40. Zollner-Schwetz, I., & Krause, R. (2015). Therapy of acute gastroenteritis: Role
of antibiotics.

17
 3.14 APPENDICES.

3.14.1 WORK PLAN

6th may 1 13th August 30th 6th 18th
8th July to to 28th October November November
October to 2022
12th august 2022 To 4th
ACTIVITY 15th 2022 November 11th
June November
2022 2022
2022

Proposal writing

Proposal presentation

Data collection

Data analysis

Report writing

Research
presentation.

18
 3.14.2BUDGET

ACTIVITY ITEM UNIT PRICE PER TOTAL

UNIT

PROPOSAL DEVELOPMENT Printing and Binding 6 150 800

NACOSTI 1 100 100

miscellaneous 2 1000 2000

DATA COLLECTION Questionnaire 108 20 2160

DATA MANAGEMENT Printing of Final report 7 250 1750

TOTAL 6810

3.14.3CONSENT FORM
I acknowledge that I have read and understood the information about this study or it has been

read to me by the investigator. I have asked questions whose answers were satisfactory. I hereby

consent voluntarily to be a participant in this study without any coercion and I am aware I can

withdraw from the study at will.

Signature of Participant ____________________________ Date ________________

19
3.14.4 QUESTIONAIRE

SECTION A: Bio data

1. Gender

a) Female

b) Male

2. Age

a) 16-20

b) 21-24

c) Above 24

3. School

a) School of Medicine (SOMED)

b) School of Pharmacy (SOPHARM)

c) School of Nursing (SON)

d) School of Public health (SoPH)

e) School of Biomedical Sciences (SOBS)

f) Other students

4. Year of Study

a) First year

b) Second year

c) Third year

d) Fourth year

e) Fifth year

f) Sixth year

20
SECTION B: Knowledge on antibiotic use.

1. Choose antibiotics from this list (Pick more than one answer)

a) Azithromycin

b) Methotrexate

c) Gentamicin

d) Allopurinol

e) Omeprazole

f) Amoxillin / Augmentin

g) Metformin

h) Penicillin

i) Ceftriaxone

2. Antibiotics are a class of drugs that kill or inhibit the growth of bacteria

a) Strongly Agree

b) Agree

c) Neutral

d) Disagree

e) Strongly disagree

3. Colds and flu are caused by?

a) Changes in weather

b) Viruses

c) Bacteria

d) Staying in the cold

21
4. Antibiotic are effective against viral infections

a) Strongly agree

b) Agree

c) Neutral

d) Disagree

e) Strongly disagree

5. Antibiotics can be used to strengthen the immune system

a) Strongly agree

b) Agree

c) Neutral

d) Disagree

e) Strongly disagree

6. Use of antibiotics without proper guidance from a duly qualified medical practitioner

increases the risk of undesirable effects like diarrhea and anaphylactic reactions.

a) Strongly agree

b) Agree

c) Neutral

d) Disagree

e) Strongly Disagree

7. Misuse of antibiotics makes bacteria used to them and become difficult to treat

a) Strongly agree

b) Agree

c) Neutral

22
 d) Disagree

e) Strongly Disagree

SECTION C: Attitudes and practices related to the antibiotic self-medication.

1. Choose antibiotics that you have used/prescribed in the past three months (Pick more

than one answer)

a) Azithromycin /Azifred

b) Gentamicin

c) Amoxicillin/Amoxiclav

d) Penicillin

e) Ceftriaxone/Rocephin/Injxone

f) Erythromycin/

g) Metronidazole/Flagyl

h) Cotrimoxazole/ Septrin /Bactrim

i) Doxycycline/ Doxicip/Doxyspor

j) Fluoroquinolones like ciprofloxacin, ofloxacin

2. I have a habit of obtaining antibiotics without a prescription.

a) Strongly agree

b) Agree

c) Neutral

d) Disagree

e) Strongly Disagree

23
 3. I'd rather take an antibiotic that may not be needed than wait to see if I get better

without it.

a) Strongly disagree

b) Disagree

c) Neutral

d) Agree

e) Strongly agree

4. If I feel better after half treatment, I stop taking a prescribed dose of antibiotics.

a) Strongly disagree

b) Disagree

c) Neutral

d) Agree

e) Strongly agree

5. Sometimes I keep left-over antibiotics for future use or give them to someone else

a) Strongly agree

b) Agree

c) Neutral

d) Disagree

e) Strongly Disagree

6. Prescribing broad spectrum antibiotics when equally effective narrow spectrum

antibiotics are available increases the risk of antibiotic resistance.

a) Strongly agree

b) Agree

24
c) Neutral

d) Disagree

e) Strongly disagree

7. I consider it necessary to have a set of laboratory tests done before prescribing or

taking

antibiotics.

a) Strongly Agree

b) Agree

c) Neutral

d) Disagree

e) Strongly disagree

25