Patterns and Determinants of Non-prescription Medication use for ENT Symptoms: A cross-sectional Study Among Patients Attending a Tertiary Care Teaching Hospital

Background: Self-medication is referred as the use of medicines without prior professional consultation, especially prevalent in lower- and middle-income countries. This pattern is particularly seen in ear, nose and throat (ENT) conditions. Unregulated antibiotic self-use in this context poses a significant threat to antimicrobial stewardship. ROBUST India-specific data quantifying this behaviour in tertiary ENT settings remain limited. The objective is to determine the prevalence of non-prescription medication among patients presenting with ENT infections at a tertiary care teaching hospital, and to identify the drug classes used, sources of procurement, reasons for self-medication and sociodemographic predictors. Material and Methods: A hospital-based cross-sectional study was conducted in the ENT outpatient of a tertiary care hospital over a period of six months. Four hundred adult patients presenting with ENT symptoms were enrolled in the study after obtaining written informed consent. A structured, pre-tested, interviewer-administered questionnaire covering sociodemographic profile, symptom characteristics, drug use, sources, reasons, and outcomes was used Categorical associations were tested using the Pearson chi-square test and independent predictors were identified by multivariate logistic regression. Results: The overall prevalence of non-prescription based medication was 62.0% (n=248/400). The mean age of participants was 32.4 ± 11.8 years, 57% were male. Ear discharge (42.9%), nasal congestion (35.5%) and throat pain (25.8%) were the most common presenting symptoms. Analgesics/antipyretics (70.9%) and antibiotics (61.3%) were the most frequently administered drug classes. Azithromycin (36.8%) was the most common antibiotic used. Community pharmacies were the primary source of medicine procurement for the patient (74.2%). Adverse effects were reported by 22.6% of non-prescription based medicines and 64.5% delayed seeking formal consultation. Conclusion: Non-prescription base antibiotics are highly prevalent among patients attending ENT OPDs of tertiary care hospital, facilitated by unregulated pharmacy dispensing and limited primary healthcare access. These findings underscore an urgent need of antimicrobial stewardship programmes, pharmacy regulation and community-based public health education.

Keywords: Non-prescription medication, Self-medication, ENT infections, Anti-microbial resistance, pharmacy dispensing.