PREVALENCE OF SELF-MEDICATION WITH ANTIBIOTICS AMONG PATIENTS ATTENDING A CLINIC FOR TREATMENT OF SEXUALLY-TRANSMITTED DISEASES

To ascertain the prevalence of self-medication with antimicrobial agen ts among patients attending a clinic for treatment of sexually transmi tted diseases (STDs), we administered a questionnaire to and collected a urine specimen for antimicrobial testing from 551 patients before t reatment. We defined self-medication as an antimicrobial agent taken o n the patient's own initiative by self-report during the week before t he visit to the clinic or a positive urine assay for antimicrobial age nts at the time of the clinic visit. We tested urine for the presence of antimicrobial agents by a disk diffusion method using Sarcina lutea as the test organism. A total of 75 (14%) of the 551 participants wer e self-medicators: 19 reported antimicrobial use and had a positive ur ine 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 thei r urine at the time of the clinic visit denied self-medication. Self-m edicators acquired their antibiotics either from their medicine cabine t (44%) or from a family member or friend (56%). Self-medication was a ssociated with self-report of prior use of unprescribed antimicrobial agents (P < .0001). We concluded that use of unprescribed antimicrobia l agents (usually beta-lactam agents or tetracyclines) among STD clini c attendees in our study was common and that self-reporting was not a reliable method of screening for self-medicators.