Table 1 General characteristics of studies about education level and misuse of antibiotics

Cohort studies

Afari-Asiedu 2020

Ghana

Adults

(< 20 to > 60)

M: 36.0%

F: 64%

General population

Any misuse

0.0

283

27

1.00

Age, gender, marital status, occupation, place of residence, health insurance, type of drug supplier

3.5

176

19

0.90 (0.40, 1.70)

8.0

138

22

0.60 (0.30, 1.10)

13.0

164

34

0.40 (0.20, 0.70)

Ho 2010

Australia

Adults (≥ 18)

≤ 30 to > 45

M: 43%

F: 57%

Emergency department attendants

Non-adherence

3.0

16

4

1.00

Age, gender, marital status, employment status, having a regular general practitioner, number of usual medications, place of birth, use of herbal medicine

9.0

70

16

0.79 (0.46, 4.55)

12.0

35

10

0.39 (0.06, 2.78)

15.5

71

9

0.33 (0.08, 1.43)

Cross-sectional studies

Moktan 2021

India

Adults (> 18)

M: 61.3%

F: 38.7%

Attendants of primary care centers

Use without prescription

0.0

28

12

1.00

Age, gender, marital status, income, public and private clinics, frequency of doctors’ consultation, family/friend influence (other family members self-medicating with antibiotics), symptoms (minor illness)

6.5

206

65

0.61 (0.28, 1.37)

14.5

158

59

0.79 (0.35, 1.80)

19.0

112

35

0.61 (0.26, 1.42)

Bianco 2020

Italy

Adults

mean ± SD: 47.8 ± 16.7

M: 41.2%

F: 58.8%

Attendants of primary care centers

Use without prescription

4.0

–

–

1.00

Age, gender, marital status, employment status, nationality, having a kid who had used antibiotics in the last year

11.0

–

–

1.38 (0.86, 2.21)

16.0

–

–

1.34 (0.78, 2.29)

Elmahi 2020

Sudan

Adults (> 18)

M: 52.8%

F: 47.2%

General population

Use without prescription

6.0

35

23

1.00

Age

14.5

211

125

0.76 (0.36, 1.61)

Hallit 2020

Lebanon

Adults

mean ± SD:

bad practice 33.33 ± 8.80

good practice 31.49 ± 6.68

M: 48.5%

F: 51.5%

Children caregivers

Any misuse

3.0

48

40

1.00

Age

11.0

40

22

0.24 (0.09, 0.65)

14.5

116

41

0.11 (0.05, 0.26)

Mallah 2020

Lebanon

Adults (> 18)

M: 19.4%

F: 76.8%

Children caregivers

Any misuse

6.0

252

31

1.00

Age, gender, income, area of residence, access to medical care facilities, frequency of telephone medical consultation

14.5

1157

62

0.40 (0.27, 0.64)

Nusair 2020

Jordan

Unrestricted age group

> 60

M: 36.6%

F: 63.4%

General population

Use without prescription

0.0

51

18

1.00

–

5.5

52

20

1.15 (0.51, 2.55)

11.5

273

104

1.13 (0.60, 2.11)

15.5

1505

632

1.33 (0.74, 2.38)

Rathish 2020

Sri Lanka

Unrestricted age group

Mean ± SD: 36.0 ± 21.0

M: 47%

F: 53%

General population

Use without prescription

11.0

252

247

1.00

–

13.5

132

127

3.95 (0.74, 21.10)

Shah 2020

Pakistan

 ≥ 15

M: 33%

F: 67%

General population

Use without prescription

0.0

45

25

1.00

Age

4.5

231

30

0.12 (0.06, 0.24)

10.5

198

54

0.30 (0.15, 0.58)

14.5

221

71

0.38 (0.20, 0.73)

Xu 2020

China

Parents with children < 13 years old

M: 21.5%

F: 78.5%

Children caregivers

Use without prescription

4.5

1344

–

1.00

Age, gender, income, medical background, residential location

11.0

1771

–

0.85 (0.58, 1.25)

14.5

3164

–

0.77 (0.53, 1.14)

Antibiotic Storage

4.5

1344

–

1.00

11.0

1771

–

1.38 (1.19, 1.60)

14.5

3164

–

1.55 (1.33, 1.81)

Ateshim 2019

Eritrea

Median (IQR): 37 (24)

M: 41.2%

F: 58.8%

General population

Use without prescription

0.0

32

11

1.00

Age, gender, income, marital status, occupational status, knowledge about antibiotics, attitudes towards antibiotics

3.0

64

22

1.96 (0.56, 6.88)

6.5

95

33

1.62 (0.46, 5.72)

9.5

246

111

1.92 (0.55, 6.69)

14.0

140

81

2.8 (0.74, 10.63)

Bogale 2019

Ethiopia

18 to > 60

M: 41.3%

F: 58.7%

General population

Use without prescription

0.0

–

26

6.39 (1.45, 28.19)

Age, gender, income, marital status, residential location, occupational status, healthcare profession

4.5

–

72

1.50 (0.82, 2.74)

10.5

–

75

1.46 (0.74, 2.87)

14.5

81

1.00

Bulabula 2019

South Africa

Mean ± SD:

29 ± 6.1

F: 100%

Pregnant women attending public hospital

Use without prescription

5.0

14

–

1.00

Age, gender, income, residential location,, knowledge about antibiotics, attitudes towards antibiotics

11.0

228

–

1.25 (0.15, 10.10)

15.5

5

–

1.60 (1.03, 2.55)

Ekambi 2019

Cameroon

≥ 15

Mean ± SD: 35.02 ± 10.5

M: 52%

F: 48%

Attendants of pharmacies

Use without prescription

3.0

25

8

1.00

Age, gender, marital status, occupation

10.0

86

28

1.02 (0.94, 2.66)

15.0

66

33

2.07 (1.10, 4.00)

Mate 2019

Mozambique

Adults (> 18)

Median (IQR): 33 (25–47)

M: 26.9%

F: 73.1%

General population

Use without prescription

0.0

69

17

1.00

Age

4.0

344

63

0.69 (0.37, 1.26)

11.5

555

119

0.83 (0.47, 1.50)

14.5

114

28

1.00 (0.50, 1.99)

Non-adherence

0.0

65

15

1.00

4.0

334

88

1.19 (0.64, 2.23)

11.5

531

177

1.67 (0.91, 3.05)

14.5

110

33

1.43 (0.70, 2.90)

Mukattash 2019

Jordan

20 to ≥ 50

M: 15.8%

F: 84.2%

Children caregivers

Use without prescription

6.0

205

106

1.00

Age

18.0

1487

554

0.56 (0.42, 0.75)

Rajendran 2019

India

Adults (> 18)

M: 51%

F: 49%

General population

Use without prescription

9.5

151

2

1.00

Age

11.0

60

2

2.57 (0.35, 18.67)

14.0

540

21

3.01 (0.70, 13.00)

Sun 2019

China

Parents with children < 13 years old

M: 23.5%

F: 76.5%

Children caregivers

Antibiotic storage

5.0

2519

1026

1.00

Age, gender of the parents, gender of the child, socioeconomic characteristics (residential location and GDP per capita), health insurance, specialty (medical vs non-medical)

11.0

2765

1365

1.34 (1.20, 1.51)

14.5

4242

2189

1.50 (1.33, 1.70)

Voidăzan 2019

Romania

Adults (20–80)

Mean ± SD:

45 ± 12.5

M: 36.5%

F: 63.5%

Attendants of primary care centers

Use without prescription

2.5

200

11

1.00

–

9.0

564

94

3.43 (1.80, 6.56)

15.0

438

102

5.22 (2.73, 9.96)

22.5

790

77

1.86 (0.97, 3.56)

Adisa 2018

Nigeria

Mothers of children under five

F: 100%

Mothers of children under five attending primary care centers

Use without prescription

3.0

19

8

1.00

Gender

9.5

148

89

2.07 (0.79, 5.46)

14.5

160

73

1.15 (0.44, 3.02)

Al-Qahtani 2018

Saudi Arabia

Adults (≥ 18)

M: 43.4%

F: 56.6%

Attendants to primary care centers

Use without prescription

0.0

13

4

1.00

Age, gender

3.5

39

13

1.13 (0.29, 4.35)

10.5

108

39

1.27 (0.37, 4.40)

15.5

281

119

1.65 (0.50, 5.49)

21.0

48

23

2.07 (0.56, 7.65)

Chang 2018

China

Caregivers of children under seven

M: 33.3%

F: 66.7%

Caregivers of children under seven

Use without prescription

4.5

336

–

1.00

Gender, child gender and age, number of children, health insurance, residential location

11.0

1428

–

0.75 (0.57, 0.98)

14.5

1407

–

0.82 (0.62, 1.08)

19.0

187

–

0.86 (0.56, 1.32)

Cheng 2018

China

30 to ≥ 71

M: 41.4%

F: 68.3%

General rural population

Use without prescription

0.0

135*

83*

1.00

Age, gender, household size, health insurance

3.5

165*

112*

1.19 (0.69, 2.05)

8.0

227*

139*

0.89 (0.50, 1.57)

13.0

97*

57*

0.84 (0.40, 1.74)

Dar-Odeh 2018

Saudi Arabia

15–64

Mean ± SD: 29.08 ± 9.32

M: 40.7%

F: 59.3%

Attendants of primary care centers

Use without prescription

6.0

138

47

1.00

Age

15.5

333

81

0.63 (0.41, 0.97)

21.0

29

7

0.62 (0.25, 1.56)

El-Sherbiny 2018

Egypt

Adults (≥ 18)

M: 50.3%

F: 49.7%

Attendants of primary care centers

Any misuse

6.0

419

–

1.00

Age, gender, income, occupation, residential location

14.5

181

–

0.52 (0.34, 0.79)

Horumpende 2018

Tanzania

Median (IQR): 23 (20.5–36.5)

M: 53.33%

F: 46.67%

General population

Use without prescription

0.0

17

9

1.00

Age, gender, income, marital status, occupation

4.0

111

70

1.45 (0.46, 4.51)

10.0

172

95

1.02 (0.32, 3.25)

Kamata 2018

Japan

20–69

M: 51.2%

F: 48.8%

General population

Antibiotic storage

5.0

111

18

1.00

Age

11.0

1265

115

0.52 (0.30, 0.89)

14.5

1932

254

0.78 (0.46, 1.32)

Non-adherence

5.0

111

26

1.00

11.0

1265

282

0.94 (0.59, 1.48)

14.5

1932

479

1.08 (0.69, 1.69)

Ngu 2018

Cameroon

≥ 21

Median (IQR): 35 (27—49)

M: 44.8%

F: 55.2%

Attendants of primary care centers

Use without prescription

0.0

29

14

1.00

Age

6.5

279

115

0.75 (0.35, 1.62)

Redzick 2018

Croatia

–

M: 26.1%

F: 73.9%

Attendants of primary care centers

Use without prescription

4.5

32

8

1.00

Age

10.5

312

38

0.42 (0.17, 0.99)

14.5

60

4

0.21 (0.06, 0.78)

19.0

140

12

0.28 (0.10, 0.76)

Tong 2018

China

< 45 to > 60

M: 47.6%

F: 52.4%

Attendants of primary care centers

Non-adherence

6.5

323

286

1.00

Age, gender, income, residential location, occupation, employment status, knowledge about antibiotics

14.5

391

335

0.77 (0.50, 1.21)

Abdelrahman 2017

Saudi Arabia

< 18 to > 65

M: 71.5%

F: 28.5%

General population

Use without prescription

0.0

8

4

1.00

Age

5.0

58

21

0.57 (0.13, 2.51)

11.0

360

117

0.48 (0.12, 1.96)

15.5

602

248

0.70 (0.17, 2.83)

Albawani 2017

Yemen

≥ 18

Mean ± SD: 28.6 ± 7.7

M: 56.2%

F: 43.8%

Attendants of pharmacies

Use without prescription

5.0

40

36

1.00

Age

11.0

71

68

2.52 (0.53, 11.87)

15.0

229

191

0.56 (0.19, 1.66)

Akici 2017

Turkey

≥ 15

M: 42.6%

F: 57.4%

Attendants of primary care centers

Use without prescription

0.0

18

8

1.00

–

4.5

18

6

0.63 (0.16, 2.41)

10.5

18

8

1.11 (0.29, 4.20)

14.5

18

9

1.25 (0.34, 4.64)

Non-adherence

0.0

9

6

1.00

4.5

9

6

1.00 (0.14, 7.10)

10.5

9

7

1.75 (0.22, 14.22)

14.5

9

7

1.75 (0.22, 14.22)

Antibiotic storage

0.0

8

3

1

4.5

9

4

1.67 (0.23, 12.22)

10.5

8

5

2.78 (0.37, 21.03)

14.5

9

6

3.33 (0.45, 24.44)

Barber 2017

Philippines

Adults (≥ 18)

Median (IQR): 32 (20)

M: 37.2%

F: 56.7%

General population

Use without prescription

3.5

83

69

1.00

Age, gender, household size

10.5

186

143

0.77 (0.30, 1.67)

Erku 2017

Ethiopia

< 29 to > 60

Mean ± SD: 33.19 ± 10.82

M: 25.9%

F: 74.9%

General population

Use without prescription

0.0

182

125

5.01 (2.62, 9.34)

Age, gender, income, marital status, household size, employment status, frequency of visiting health care institutions, satisfaction about healthcare service

4.5

201

180

2.81 (1.32, 6.15)

10.5

179

159

1.96 (0.91, 4.51)

14.5

88

71

1.00

Gebrekirstos 2017

Ethiopia

Adults (≥ 18)

Median (IQR): 30 (16)

M: 60.6%

F: 39.4%

Attendants of pharmacies

Use without prescription

0.0

152

75

1.00

Age, gender, income, marital status, employment status, household size, residential location, type of illness, healthcare insurance, previous experience with antibiotics, access to healthcare

4.5

149

71

0.93 (0.59, 1.47)

10.5

260

121

0.89 (0.60, 1.33)

14.5

219

100

0.86 (0.60, 1.31)

Hassali 2017

Malaysia

Adults (≥ 18)

Mean ± SD: 28.7 ± 7.4

M: 42.75%

F: 57.25%

General population

Any misuse

8.5

61

20

1.00

Age, gender, income, marital status, race, healthcare related occupation, employment status, health insurance

14.0

339

111

0.83 (0.53, 1.31)

Jamhour 2017

Lebanon

Adults (≥ 18)

M: 45.5%

F: 54.5%

General population

Use without prescription

4.5

34

14

1.00

Age, gender, educational level, specialty (unrelated to health care)

11.0

151

76

1.45 (0.68, 3.08)

Kajeguka 2017

Tanzania

Adults (≥ 18)

Mean ± SD: 35.4 ± 13.4

M: 48.0%

F: 52.0%

General population

Use without prescription

0.0

26

16

1.00

Age, gender, income, marital status, employment status, self-treated condition

4.0

87

33

0.38 (0.12, 0.94)

11.0

74

46

1.03 (0.41, 2.57)

16.0

133

72

1.10 (0.46, 2.64)

Kurniawan 2017

Indonesia

Adults (≥ 18)

Median (IQR): 45 (18–49)

M: 34.3%

F: 65.8%

Attendants of primary care centers

Use without prescription

3.5

26

24

1.00

Age, gender, income, marital status, employment status, health insurance

8.0

44

37

0.44 (0.08, 2.30)

11.0

139

101

0.22 (0.05, 0.98)

14.5

31

18

0.12 (0.02, 0.58)

Senadheera 2017

Sri Lanka

Adults (≥ 18)

M: 31.30%

F: 68.70%

General population

Use without prescription

11.0

362

14

1.00

Age, gender, income, employment status, health insurance, household size, receiving medical treatment in the last three months, knowledge of antibiotic name

13.5

245

37

0.32 (0.17, 0.63)

Torres 2017

Ecuador

Adults (≥ 18)

range: 18—64

M: 45.6%

F: 54.4%

General population

Use without prescription

3.5

51

22

1.00

Age

10.5

173

83

1.22 (0.65, 2.28)

14.5

195

102

1.45 (0.78, 2.69)

Abdulraheem 2016

Nigeria

Adults (≥ 18)

Median (range): 25 (19–68)

M: 61.1%

F: 38.9%

Attendants of primary care centers

Use without prescription

3.5

623

–

1.00

Age, gender, symptoms, occupation

9.5

390

–

1.24 (1.13, 1.87)

14.5

137

–

1.32 (1.18, 1.96)

Aleem 2016

Saudi Arabia

< 25 to ≥ 55

M: 39.5%

F: 60.5%

Children caregivers

Use without prescription

6.0

102

29

1.00

Age, gender, income, household size

15.0

508

42

0.23 (0.13, 0.39)

Al Rasheed 2016

Saudi Arabia

Adults (> 18)

M: 23.2%

F: 76.8%

Attendants of primary care centers

Use without prescription

0.0

100

13

1.00

Age, gender, marital status, employment status, occupation, symptoms

3.5

186

16

1.59 (0.73, 3.45)

10.5

145

13

1.52 (0.67, 3.43)

15.5

145

50

0.28 (0.14, 0.59)

Bilal 2016

Pakistan

Mean ± SD: 48.6 ± 4.4

M: 65.8%

F: 34.2%

Attendants of primary care centers

Use without prescription

0.0

161

159

1.00

Age, residential location, specialty (non-medical related participants)

9.5

86

81

0.20 (0.04, 1.07)

11.5

65

49

0.04 (0.01, 0.17)

14.5

50

26

0.01 (0.003, 0.06)

19.5

38

10

0.004 (0.001, 0.02)

Nigigi 2016

Kenya

Adults (≥ 18)

M: 32.0%

F: 68.0%

Attendants of primary care centers

Use without prescription

0.0

48

12

1.00

–

4.0

115

35

1.13 (0.90, 1.97)

9.5

179

61

1.31 (0.92, 2.40)

13.5

20

9

1.57 (1.20, 2.50)

Ding 2015

China

Adults

≤ 29 to > 50

M: 9.7%

F: 90.3%

Children caregivers

Non-adherence

3.0

198

68

1.00

Age, access to healthcare (number of clinics)

8.0

304

87

0.77 (0.52, 1.13)

13.0

120

47

1.23 (0.77, 1.97)

Gebeyehu 2015

Ethiopia

Mean ± SD:

urban:

34.1 ± 12.9

rural:

34.5 ± 11.5

M: 24.3%

F: 75.7%

General population

Use without prescription

0.0

137

56

4.21 (1.47, 12.07)

Age, gender, educational level, marital status, employment status, residential location, household size, level of healthcare service satisfaction, knowledge on antibiotics use

4.5

145

40

2.01 (0.93, 4.34)

10.5

89

14

1.01 (0.34, 2.94)

14.5

35

10

1

Kusturica 2015

Serbia

Adults (≥ 18)

M: 20.1%

F: 79.9%

General population

Antibiotic storage

4.5

27

9

1.00

Age

10.5

169

75

1.60 (0.68, 3.76)

14.0

25

10

2.53 (0.89, 7.23)

16.5

162

84

2.15 (0.91, 5.08)

Pavyde 2015

Lithuania

Adults (≥ 18)

Mean ± SD: 38.6 ± 13.9

M: 42.1%

F: 57.9%

Attendants of pharmacies

Use without prescription

6.0

298

–

1.00

Age, gender, residential location, parenthood, knowledge of antibiotics, occupation

14.5

707

–

1.39 (0.90, 2.16)

Yousif 2015

Saudi Arabia

Adults (≥ 18)

M: 57.0%

F: 43.0%

General population

Use without prescription

6.0

96

80

1.00

Age, gender, income, marital status, employment status, residential location

15.5

295

235

1.25 (0.71, 2.50)

Cheaito 2014

Lebanon

Adults (≥ 18)

Mean ± SD: 38.24 ± 13.7

M: 44.8%

F: 55.2%

Attendants of pharmacies

Use without prescription

3.0

67

34

1.00

Age, gender, income, marital status, employment status, health insurance, having a reference doctor and frequency of consultation

10.5

96

42

0.75 (0.40, 1.41)

17.5

156

58

0.57 (0.32, 1.02)

Vásquez 2014

Ecuador

≥ 65

M: 45.8%

F: 54.2%

General population

Use without prescription

3.0

463

52

1.00

Age

11.5

205

26

1.15 (0.69, 1.90)

Hu 2014

Australia

≥ 14

Mean ± SD:

33 ± 8.2

M: 45.0%

F: 55.0%

General population

Use without prescription

6.0

67

14

1.00

Age, gender, income, residential location, employment status, marital status, parental status, language proficiency, main language spoken at home, health insurance

14.5

402

134

1.89 (1.01, 3.53)

Mihretie 2014

Ethiopia

≥ 17

Mean ± SD: 37.8 ± 12.2

M: 4.4%

F: 95.6%

General population

Use without prescription

4.0

29

27

1.00

Age

10.5

7

3

0.06 (0.01, 0.44)

14.5

9

4

0.06 (0.01, 0.42)

Ramalhinho 2014

Portugal

Adults (≥ 18)

M: 48.7%

F: 51.3%

General population

Use without prescription

4.5

308*

268*

0.84 (1.41, 11.78)

Age, gender, marital status, employment status, residential location, access to healthcare, chronic disease, easy access to unprescribed antibiotics, occupation

11.0

445*

340*

1.25 (0.66, 5.45)

15.5

293*

223*

1.00

Yu 2014

China

Adults

≤ 20 to > 40

M: 25.6%

F: 74.4%

Children caregivers

Use without prescription

3.5

16

–

0.19 (0.05, 0.75)

Age, gender, child age, number of children, medical insurance

8.0

371

–

1.07 (0.64, 1.81)

11.0

258

–

1.01 (0.62, 1.65)

14.5

203

–

1.00

Abobotain 2013

Saudi Arabia

< 25 to ≥ 55

M: 39.5%

F: 60.5%

Children caregivers

Use without prescription

6.0

102

29

1.00

Age, income, marital status, household size, number of children, healthcare related profession

14.5

508

42

0.23 (0.13, 0.39)

Ecker 2013

Peru

Mean ± SD: 31.4 ± 10.8

F: > 94.9%

Children caregivers

Use without prescription

3.5

188

–

1.00

Age, gender, caregiver-child relatedness, age of the child, access to healthcare

9.0

781

–

1.2 (0.7, 1.9)

14.5

232

–

1.0 (0.5, 1.7)

Ekwochi 2013

Nigeria

–

M: 59.0%

F: 41.0%

Children caregivers

Use without prescription

3.0

31

19

1.00

–

9.5

83

45

0.75 (0.32, 1.74)

14.5

96

34

0.35 (0.15, 0.80)

Ivanovska 2013

Macedonia

Adults (≥ 18)

M: 31.3%

F: 68.7%

General population

Use without prescription

0.0

11

4

1.00

Age, occupation

5.0

41

21

1.83 (0.47, 7.25)

11.5

256

112

1.36 (0.39, 4.77)

16.0

94

37

1.14 (0.31, 4.15)

Antibiotic storage

0.0

11

6

1.00

5.0

41

28

1.79 (0.46, 6.97)

11.5

256

187

2.26 (0.67, 7.64)

16.0

94

66

1.96 (0.55, 6.97)

Khalil 2013

Saudi Arabia

≥ 15

M: 80.8%

F: 19.1%

Attendants of primary care centers

Use without prescription

4.5

107

93

1.00

–

11.0

435

350

0.62 (0.34, 1.14)

15.5

233

180

0.51 (0.27, 0.97)

21.0

18

14

0.53 (0.15, 1.83)

Moradi 2013

Iran

Mean ± SD: 29.2 ± 8.05

M: 33.3%

F: 66.7%

Attendants of pharmacies and primary care centers

Non-adherence

2.5

23

16

1.00

–

11.0

50

36

1.13 (0.38, 3.32)

15.5

19

6

0.20 (0.05, 0.75)

Chan 2012

Hong Kong, China

Adults (≥ 18)

M: 46.0%

F: 54.0%

General population

Non-adherence

3.0

47

–

1.00

Age, gender, antibiotic knowledge

9.5

165

–

1.77 (0.76, 4.11)

14.5

150

–

2.18 (0.85, 5.55)

Elberry 2012

Saudi Arabia

≥ 20

F: 100%

Mothers

Use without prescription

6.0

34

2

1.00

Gender

15.5

116

11

1.68 (0.35, 7.96)

21.0

49

6

2.23 (0.42, 11.79)

Grosso 2012

Italy

< 25 to > 65

M: 43.1%

F: 56.9%

Attendants of primary care centers

Use without prescription

4.0

489

82

0.39 (0.26, 0.61)

Age, gender, occupation

11.0

268

61

0.41 (0.26, 0.64)

16.0

176

74

1.00

Non-adherence

4.0

502

169

1.77 (1.13, 2.75)

11.0

276

45

0.79 (0.48, 1.31)

16.0

178

33

1.00

Clark 2011

Azerbaijan

Adults (≥ 18)

M: 43.6%

F: 56.4%

General population

Use without prescription

0.0

35

8

1.00

Age, gender, ethnicity, household size

7.0

646

123

1.23 (0.45, 3.36)

10.5

74

14

1.25 (0.37, 4.17)

13.5

37

9

1.48 (0.37, 5.93)

Widayati 2011

Indonesia

Adults (≥ 18)

M: 38.3%

F: 61.7%

General population

Use without prescription

3.5

8

5

1.00

Age, gender, income, marital status, household size, employment status, healthcare insurance

8.0

8

3

0.36 (0.05, 2.73)

11.0

31

17

0.73 (0.15, 3.60)

14.5

21

8

0.37 (0.07, 1.98)

Barah 2010

Syria

Adults (≥ 18)

M: 52%

F: 48%

General population

Use without prescription

5.0

80

54

1.00

Age

11.0

83

66

1.87 (0.92, 3.80)

15.5

89

55

0.78 (0.42, 1.47)

21.0

90

57

0.83 (0.44, 1.57)

Landers 2010

United States

Mean ± SD: 33.7 ± 8.7

F: 100%

General population

Use without prescription

4.5

31

11

1.00

Age, gender

13.0

42

18

1.36 (0.52, 3.55)

Sawalha 2010

Palestine

–

NA

General population

Antibiotic Storage

3.5

239

86

1.00

–

10.0

591

162

0.67 (0.49, 0.93)

Togoobaatar 2010

Mongolia

Mean ± SD: 35.4 ± 11.9

F: 100%

General population

Use without prescription

5.0

183

–

1.20 (0.70, 2.20)

Gender, occupation

12.0

320

–

1.00

Abasaeed 2009

United Arab Emirates

Adults

 ≤ 20 to > 50

M: 65.8%

F: 34.2%

Attendants of a book fair

Antibiotic storage

3.5

163

37

1.00

Age

11.0

191

48

1.14 (0.70, 1.87)

15.5

496

166

1.71 (1.14, 2.58)

Ilhan 2009

Turkey

Adults (≥ 18)

Mean ± SD: 39.5 ± 15.2

M: 38.7%

F: 61.3%

Attendants of primary care centers

Use without prescription

4.0

906

141

1.00

Age, gender, income, marital status, employment status, household size, healthcare insurance (social security), perceived health status, presence of chronic diseases

12.5

1787

373

1.43 (1.15, 1.78)

Sawair 2009

Jordan

16–65

M: 46.1%

F: 53.9%

Attendants of primary care centers

Use without prescription

0.0

14

7

1.00

Age, gender, income, marital status, employment status, healthcare insurance, smoking habits, self-reported health status, chronic comorbidities

5.5

37

15

0.68 (0.20, 2.35)

11.5

203

77

0.61 (0.21, 1.81)

15.5

198

85

0.75 (0.25, 2.23)

21.0

25

10

0.67 (0.18, 2.49)

Hadi 2008

Indonesia

Adults (≥ 18)

M: 37.4%

F: 62.6%

Attendants of primary care centers

Use without prescription

2.5

63

26

1.00

Age, gender, income, residential location, ethnicity, household size, healthcare insurance

6.0

402

192

1.30 (0.76, 2.22)

Mistretta 2008

Italy

 ≥ 10

Mean ± SD: 53.7 ± 17.7

M: 41.3%

F: 58.7%

Attendants of primary care centers

Use without prescription

2.5

144

124

1.00

Age, gender, occupation, family size

7.0

165

142

0.73 (0.36, 1.46)

11.0

195

160

0.62 (0.30, 1.28)

16.0

132

86

1.37 (0.65, 2.86)

Al-Azzam 2007

Jordan

Unrestricted age category

> 17 to < 60

M: 48.8%

F: 51.2%

General population

Use without prescription

0.0

315

86

1.00

–

5.5

396

143

1.51 (1.09, 2.08)

11.5

709

313

2.10 (1.58, 2.81)

15.5

713

300

1.93 (1.45, 2.58)

Grigoryan 2006

19 European countries

Adults (≥ 18)

M: 46.8%

F: 53.2%

General population

Use without prescription

6.0

–

–

1.00

Age, gender, country, chronic diseases

14.0

–

–

1.36 (1.10, 1.68)

Antibiotic storage

6.0

–

–

1.00

14.0

–

–

1.69 (1.47, 1.94)

Awad 2005

Sudan

 ≤ 20 to > 60

M: 45.1%

F: 54.9%

General population

Use without prescription

0.0

156

63

1.00

Age, gender, income

3.5

285

155

1.76 (1.18, 2.61)

7.5

392

262

2.98 (2.03, 4.36)

10.0

474

413

9.99 (6.58, 15.18)

14.5

443

400

13.73 (8.77, 21.51)

Parimi 2002

Trinidad

and Tobago

Adults (≥ 18)

M: 33.3%

F: 66.7%

General population

Use without prescription

3.5

126

34

1.00

Age

9.5

323

71

0.76 (0.47, 1.22)

14.5

147

25

0.55 (0.31, 0.99)

Antibiotic storage

3.5

124

26

1.00

9.5

308

74

1.19 (0.72, 1.98)

14.5

147

28

0.89 (0.49, 1.61)

Bi 2000

China

–

F: 100%

Children caregivers

Use without prescription

3.5

140

65

1.00

Gender

8.0

442

259

1.63 (1.11, 2.39)

11.0

780

478

1.83 (1.27, 2.62)

14.5

97

65

2.34 (1.37, 4.01)

Saradamma 2000

India

> 6

M: 48.5%

F: 51.5%

General population

Use without prescription

4.0

87

38

1.00

–

10.5

136

24

0.28 (0.15, 0.51)

14.5

137

8

0.08 (0.04, 0.18)

19.0

45

3

0.09 (0.03, 0.32)