“Pill-popping Gone Bad: The Antibiotic Self-Medication Practices

of Residents Of Iloilo City”.

By Alex Bernard R. Francia, Carla Angela O. Ladrido, Evevani D. Sayson,
Timothy John V. Concio
Ateneo de Iloilo-SMCS, Atria Park District, San Rafael, Mandurriao Iloilo City

Abstract
The self-medication of antibiotics has been a major cause antimicrobial resistance,
wherein standard treatment becomes ineffective due to pathogens becoming resistant
from effects of antimicrobial drugs such as antibiotics (Department of Health, Ireland,
2017). In the context of this research, Antibiotic Self-medication refers to the practice of
diagnosing and treating ailments using antibiotics without the consent or consultation of
an accredited medical professional.

The researchers conducted this descriptive study in the hopes of exploring the practice
and prevalence of antibiotic self-medication among the residents of Iloilo City. The
researchers also delve into vital variables that surround the self-medication of antibiotics
such as key factors, sources of acquisition, and symptoms. This research made use of
multi-stage sampling method to select barangays from within the city, households from
within the selected barangays, and individuals from the selected households to participate
in the study. Cronbach’s alpha was used to measure instrument consistency. Data
collected from the research instrument was grouped, tallied and presented with
corresponding percentages. Descriptive data from interviews were noted and considered
alongside the quantitative data during analysis.

The research revealed that about 39.58% of the residents of Iloilo city self
medicate, 96.71% of which self-medicate with amoxicillin. It was found that 62.50% of
the self-medicating population did so in order to avoid the extra cost of consultation fees.
59.21% of the self-medicating population also explained that past experiences with
antibiotics led them to self-medicate. Sari-sari stores were sources of antibiotics for about
48.03% of the self-medicating population, while 44.74% of the same population acquired
their antibiotics from drug stores and pharmacies. Among self-medicators, toothaches,
wounds, and cough were the most frequently reported symptoms that lead to self-
medication, with percentage values of 42.11%, 35.53%, and 30.92%, respectively.

These findings are fundamental in improving on local government policies

regarding the act of self-medication of antibiotics and prevention of antibiotic resistance
among residents of Iloilo City.
Keywords:
Self-medication, Antibiotics, Antimicrobial Resistance, Iloilo City

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Introduction

Self-medication is defined as the practice of diagnosing and treating ailments

using non-prescription drugs without the consent or consultation of an accredited medical
professional (Annadurai, 2017). It is a practice that is generally advocated against by the
World Health Organization (WHO) due to its many negative effects, with antimicrobial
resistance being a very significant one. While WHO does discourage the use of
antibiotics without professional consultation, it does acknowledge the many benefits that
come with responsible self-medication as a form of self-care, especially with over-the-
counter (OTC) drugs.

This is a world-wide phenomenon present in both developed and developing

countries. The act of self-medication, especially to ordinary individuals without
specialized knowledge in pharmacology creates potential risks such as incorrect self-
diagnosis, inadequate or excessive dosage, and risks of abuse (World Health
Organization, 2000). In the Philippines, antibiotics account for 15 - 30% of drug
expenditures, the largest of any therapeutic group of drugs. Ampicillin was the most
common antibiotic prescribed by the physicians and used as self-medication (Hardon,
1991). In particular, irrational use of antibiotics has been a major cause antimicrobial
resistance, wherein standard treatment becomes ineffective due to pathogens becoming
resistant from effects of antimicrobial drugs such as antibiotics (Department of Health,
Ireland, 2017). This has further led to medical consequences at the macro-level such as
unnecessary increase in health cost and increased morbidity (Department of Health, and
Inter-agency Committee on Antimicrobial Resistance, 2015).

Poverty, lack of doctors, and increasing cost of treatments are just a few reasons
why people choose to self-medicate. Several researches point that consumers rely on the
internet, peers, and family members as their source of information regarding the drugs
they use to self-medicate. Among many other negative side-effects, it is also proven that
the abuse of self-medication may result to antibiotic immunity (Bennadi, 2013). The
recognized effects of inappropriate use of drugs (whether overuse or underuse) of
antibiotics includes: rapid emergence of resistance, selection pressure on resistant
microorganisms, adverse reactions, treatment failures, occurrence of preventable
morbidity and mortality, and waste of resources. The Philippines, compared to other
countries has had the smallest percentage of prescriptions filled by doctors, with non-
medical sources being the most common source of antibiotics (Dy, E.E.R, 1997).
Furthermore, the Philippines has been reported to have one of the highest rates of
antibiotic sharing with a reported prevalence range of 31-66% (Kardas, P., et al., 2007).

Despite studies by medical scholars, the cause, frequency, and predisposing

factors for self-reported self-medication is highly variable across countries. In a 2017
study in India, males were reported to self-medicate more than females (Annadurai, K.,
2017) but a similar study in Jordan in 2005 pointed out that females have tendencies to
self-medicate (Al-Hassan and Omran, 2005). These are both in contrary to studies in

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North East India and Mexico that gender differences have no significant effect among
self-medication users. (Chakraborty K., 2012., Pagan, 2006). Factors such as sex,
educational status, and age may vary as according to their socio-cultural context.

Research on self-medication has been inconsistent in producing a common pattern

on data as to why and how people self-medicate. In a study conducted by Manasco
(2008), it was stated that Factors that affect the medication practices of an individual,
perceived severity for example, have resulted with varying effects (Manasco, 2008).
Therefore, there exists a need to conduct further testing to validate the effects of known
determinants of self-medication, and also to determine whether there are other
determinants that have not yet been identified.

At the national level, there is little data regarding the prevalence of self-
medication largely due to statistical data gathering and analysis of the said topic not being
a priority of neither the Department of Health (DOH) nor the Food and Drug Association,
according to Ma. Angeles Guzman, the FDA supervisor of Region six. Furthermore, there
is a lack of extensive research on the subject has been conducted within the city of Iloilo.

Because Iloilo City currently lacks a substantial amount of literature on self-

medication, this study aims to contribute to the medical body of knowledge and provide
data for local authorities in creating strategies and regulations pertaining to proper self-
medication.

Rational Choice Theory was used as a basis for a theoretical explanation of the
practice of self-medication. This study benefits greatly from the theory because it offers
a theoretical explanation of how individuals choose self-medication over other risk-free
alternatives. This is evident in the fact that people medicate with intentionality. In other
words, people consider the benefits and costs of the possible outcomes of each action,
which in the context of this study is the self-medication of antibiotics. This study
employs the assumption that self-medication is a rational choice that takes into account
set constraints. In summary, this research attempts to understand self-medication as a
rational choice through the application of the optimization of utility, preferences and
constraints, and the discreteness and the purposefulness of the individual.

The researchers will investigate Iloilo city’s current status regarding prevalence of
self-medication practices. The factors that affect habits and tendencies of residents to
purchase and consume antibiotics without prescription will also be explored. Specifically,
the researchers aim to provide answers to the following questions: How prevalent is self-
medication in Iloilo city? What socioeconomic factors predispose residents of Iloilo City
to self-medicate? Where do self-medicating residents of Iloilo City acquire their
antibiotics? What are the illnesses residents of Iloilo City are self-medicating for? The
researchers also intend to gather data regarding the kinds of antibiotics used.

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 The issue of irrational antibiotic use in Iloilo city will be explored through a
survey and interview method of data collection. The respondents of this research will be
individuals no younger than 16 years of age coming from randomly sampled barangays
within the city of Iloilo. Data collection will begin within the month of December 2017,
and is expected to end by January 2018.

The purpose of this research is to determine the prevalence of self-medication

among residents of Iloilo City. The researchers aim to offer statistical data and in-depth
analysis of self-medicating behaviors of the local residents to the health authorities to
create strategies and improve regulations on self-medication. This study also intends to
raise public awareness on the adverse effects on irresponsible antibiotic consumption.

Materials and Methods

This part of the paper presents the research design, sampling method,
instrumentation and data collection methods.
The issue of antibiotic self-medication in Iloilo City can be partially addressed
through the collection and analysis of data. The intent of this research is to determine the
prevalence of antibiotic self-medication in Iloilo City. This research aims to accomplish
this using Survey and Interview-based methods. The respondents of this research are the
residents of the city of Iloilo, which were chosen through a multistage sampling method
involving two stages of simple random sampling. Survey questionnaires and interviews
were the instruments used in this research. Data collection began within the month of
December 2017, and ended by January 2018. The results of the study may assist the local
government enforce legal measures to further regulate the sale and distribution of
prescription drugs and most importantly, strengthen existing pharmaceutical policies.
This is a descriptive, cross sectional research with the use of survey methods.
Descriptive research is a type of research that “presents a picture of the specific details of
a situation, social setting, or relationship” (Neuman, 2007). This study seeks to
investigate the prevalence of self-medication of antibiotics in Iloilo City by looking into
its instances, predispositions, and sources of acquisition. This makes this research
essentially a descriptive one.

To the extent that this study involved a singular wave of data collection, it is
therefore a cross sectional research. As according to Bryman (2008), a cross sectional
research design involves the collection of data on more than one case at a single period of
time. This design enabled the researchers to gather the necessary information from their
respondents on several occurrences. Generally speaking, this research design also allows
for data collection in which information is gathered through interviews or through the use
of questionnaires (Sarantakos, 1993). In the context of this study, semi-structured
interview was conducted with each of the randomly selected individuals from the sample.

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 The respondents of this research were individuals from randomly sampled
barangays within the city of Iloilo. These individuals were given consent forms prior to
the distribution of questionnaires to ensure that each of the potential participants were
fully aware of the research purpose and privacy policies of this study.

This research seeks to conduct the investigation within the city of Iloilo from
December 2017 to January 2018. The time elapsed for the data collection procedure
spanned approximately 11 days in total which were distributed within the months of
December 2017 and January 2018. The research setting has a land area of 7,834 hectares,
consisting of seven districts and one hundred eighty (180) barangays. As of the year
2015, the city had a total population of 447,992, according to the Philippine Statistical
Authority. It is a highly urbanized city that is home to several secondary and tertiary
hospitals, and numerous pharmacies and drugstores. There are a total of ten hospitals, two
of which are government owned and the rest are private hospitals or medical centers.
A survey method with the use of questionnaires was employed in this study.
According to Neuman (2007), survey research allows the researcher to develop an
instrument - a survey questionnaire - that can measure the variables included in the study.
In this type of instrumentation, respondents read the questions themselves and mark
answers on a questionnaire. The same method was followed in this study. The researchers
read the questions to the respondents only if the situation is too ill-timed or inconvenient.
A questionnaire was developed in order to collect information about the respondents’
profiles, instances of self-medication, types of antibiotics used, their sources, and the
condition that they self-medicated for.

The instrument was subjected to content validation, pilot testing, and reliability
testing. A panel of experts was constituted in order to check the content validity of the
instrument. The panel consisted of a Hiligaynon and English linguists, a research
methods expert, a pharmacist, a licensed physician. The instrument will be revised based
on the recommendations of the members of the said panel.

After content validation, the instrument was further subjected to pilot testing in
Oton, Iloilo. Thirty respondents were randomly selected in the area to accomplish the
survey. After the responses were collected, the data was subjected to reliability testing.
The internal consistency of the instrument measured using Cronbach’s alpha. It is
a measure of internal consistency whereby the closeness of each item to one another is
determined (Triola, 2012). Should the value of Cronbach’s alpha turn out higher than
0.75, the instruments will prove to be reliable. In this case, the instrument can finally be
administered in the actual data collection.

The study will employ a multi-stage sampling method. In the first stage, sample
barangays will be chosen from the 180 total barangays in Iloilo City. In the second stage,
households will be sampled from each chosen barangay using a simple random sampling.
Finally, in the third stage, a simple random sampling of individuals will be used in order
to identify specific respondents from each household.

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 The sample size will be computed using the following Cochran’s sample size
determination formula:

The researchers will use official documents from the Iloilo City government to
determine the official list of barangays in the City and population for each barangay.
From that list, sample barangays will be identified.

The data collection phase will span from the months of December 2017 and January
2018. Letters will be sent to the city and barangay officials to inform them about the
researchers’ intent to conduct the survey within the residents of their area.

Respondents will be given an Informed Consent Form explaining to them the nature and
intent of the survey. Each of them will sign a conforme stating that they agree to
participate in the study and that data gathered from them may be used for academic
purposes.

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Results and Discussions
This study looks into the prevalence of antibiotics self-medication among
residents in Iloilo City and seeks to identify key factors that contribute to this practice.
Also included in the discussion are the sources of acquisition of antibiotics and the
symptoms for which they were used.

Prevalence of Antibiotics Self-Medication in Iloilo City

The views and attitudes toward antibiotic self-medication of the residents among
the eleven barangays of Iloilo City were tabulated with the use of counts and percentages.

Table 1. Use of Antibiotics without Prescription in the Past Twelve Months

Frequency
Used Antibiotics without Doctor’s Prescription Percentage (%)
(n=384)

No 232 60.42%

Yes 152 39.58%

Table 1 presents the respondents’ use and consumption of antibiotics. Based on a

survey of 384 respondents from eleven barangays in Iloilo City, it was found that 232 or
60.42% did not use antibiotics without a doctor’s prescription in the last twelve months,
while 152 or 39.58% had self-medicated with antibiotics in the same period.

Table 2. Frequency of Use of Antibiotics without Doctor’s Prescription

Percentage
Percentage of
Frequency Population (%) of Self-
No. of Times Used
(n=384) Medicating
(%)
People (152)

Once 28 7.29% 18.42%

2-3 Times 65 16.93% 42.76%

4-5 Times 18 4.69% 11.84%

More than 6 Times 41 10.68% 26.97%

In Table 2, it can be observed that among those who self-medicated with

antibiotics, 65 or 42.76% reported to have self-medicated with antibiotics for two to three
times, and 41 or 26.97% admitted to using antibiotics without a doctor’s prescription for
more than six times in the past year.

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 Table 3. Types of Antibiotics used by People who Self-Medicated
Percentage (%)
Frequency of Self-
Type of Antibiotics Used Percentage (%)
(n=384) Medicating
People (152)

Can’t remember 0 0.00% 0.00%

Don’t know 2 0.52% 1.32%

Amoxicillin 147 38.28% 96.71%

Amoxicillin + Clavulanic Acid 6 1.56% 3.95%

Azithromycin 1 0.26% 0.66%

Cefaclor 2 0.52% 1.32%

Cefalexin 44 11.46% 28.95%

Cefuroxime 4 1.04% 2.63%

Ciprofloxacin 3 0.78% 1.97%

Clarithromycin 1 0.26% 0.66%

Clindamycin 1 0.26% 0.66%

Cotramoxizole / Trimethoprim +
5 1.30% 3.29%
Sulfamethoxazole

Erythromycin 6 1.56% 3.95%

Gentamycin 1 0.26% 0.66%

Metronidazole 3 0.78% 1.97%

Moxifloxacin 0 0.00% 0.00%

Mupirocin 0 0.00% 0.00%

Ofloxacin 1 0.26% 0.66%

TB Antibiotics 0 0.00% 0.00%

others (penicillin) 1 0.26% 0.66%

Table 3 indicates that Amoxicillin and Cephalexin were found to be the most
frequently used in self-medication. Amoxicillin was found to have been used by 147 or
96.71% of the self-medicating respondents, while 44 or 28.95% of them had used
Cefalexin.

A number of people admitted that they have become accustomed to using

amoxicillin because it was prescribed to them by a dentist in the past in order to prevent
infection from tooth extraction or other previous dental procedures. During interviews,
several respondents directly associated symptoms such as toothache to the use of
amoxicillin.

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 This implies that antibiotics are being constantly being reused for self-medication.
This is due to the cultural belief that certain antibiotics are always the go-to drugs for
certain symptoms. One respondent asserted that as soon as the pain has subsided, it is
acceptable to cease the full dosage. Dosage compliance was thus discovered as a major
issue among self-medicating respondents. Another example is when amoxicillin was used
and has been perceived successful in treating a symptom such as cough, the user would
tend to take amoxicillin whenever the same symptom would occur, thereby increasing
that person’s chance of developing resistance to amoxicillin while simultaneously
decreasing that person's tendency to seek medical attention.

Factors that Predispose People toward Antibiotic Self-Medication

Tables 4a to 4d show the different factors that predispose people towards self-
medication with antibiotics.
It was found that among the sampled population of residents in Iloilo City, 95 or
62.50% of the self-medicating population chose to self-medicate with antibiotics in order
to avoid paying extra for doctor’s consultation fees. The second highest reason for
choosing to self-medicate was to avoid the cost of expensive branded medicine, which
comprised of 49 or 32.24% of the self-medicating population.

Table 4a. Cost as Factor for People’s Self-Medication with Antibiotics

Percentage
Frequency Percentage (%) of Self-
Cost
(n=384) (%) Medicating
People (152)

avoid paying extra for doctor’s consultation

95 24.74% 62.50%
fees

save on transportation in going to the

28 7.29% 18.42%
doctor’s clinic

avoid the cost of expensive branded

49 12.76% 32.24%
medicine

avoid additional laboratory fees 16 4.17% 10.53%

avoid the possibility of hospital expenses 39 10.16% 25.66%

avoid waiting for the doctor 42 10.94% 27.63%

others 1 0.26% 0.66%

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Table 4b. Fear as Factor for People’s Self-Medication with Antibiotics
Percentage
Frequency Percentage (%) of Self-
Fear
(n=384) (%) Medicating
People (152)

afraid of doctors 1 0.26% 0.66%

do not trust doctors 5 1.30% 3.29%

afraid of the possible procedures to be done

4 1.04% 2.63%
in the hospital

afraid of knowing more about my health

8 2.08% 5.26%
condition

others 0 0.00% 0.00%

Table 4c. External Factors for People’s Self-Medication with Antibiotics

Percentage
Frequency Percentage (%) of Self-
External Influence
(n=384) (%) Medicating
People (152)

family 51 13.28% 33.55%

friends 28 7.29% 18.42%

neighbors 16 4.17% 10.53%

workmates 4 1.04% 2.63%

others 2 0.52% 1.32%

Table 4d. Personal Factors for People’s Self-Medication with Antibiotics

Percentage
Frequency Percentage (%) of Self-
Personal Experience
(n=384) (%) Medicating
People (152)

used internet to diagnose and medicate 6 1.56% 3.95%

prior symptoms and use of antibiotics 90 23.44% 59.21%

got used to it 32 8.33% 21.05%

condition was not serious 13 3.39% 8.55%

others 11 2.86% 7.24%

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 External influence also played a role in influencing people to self-medicate.
Among all the reasons, family was the top influence in people’s decision to self-medicate
with antibiotics, which is 33.55% or 51 respondents among those who self-medicated.

Among the reasons listed in personal experience, 90 or 59.21% of the self-

medicating respondents reported to have had experienced similar symptoms before and
had used the same antibiotics prescribed to them in the past. Also, 32 or 21.05% said that
they chose to self-medicate because they got used to using antibiotics regularly.

During the interviews with the respondents, many have reasoned out that the
practice of self-medication was “naandan” or was learned from the behavior of family
members when presented with a similar illness. For many, this practice has become a
norm adopted and shared from generation to generation.

The findings of Lansang similarly reflect this behavior. It was found out that the cultural
concept of “hiyang” among self-medicating users of Luzon limited their ability to
purchase the full course of the antibiotic. If a particular drug was led to be used
frequently if it was initially perceived useful in the treatment of a patient’s certain illness.

Sources of Acquisition of Antibiotics

Out of the 105 respondents who professed to have self-medicated, 73 or 48.03%
acquired their antibiotics without the need for a doctor’s prescription from sari-sari
stores, 68 or 44.74% from drugstores, and 28 or 18.42% obtained from the Barangay
Health Center. This is reflected in Table 5.

It was discovered that sari-sari stores were the primary sources where the users
acquired their antibiotics for self-medication. These small businesses did not require any
prescription when selling these drugs. One store owner proclaimed that the selling of
antibiotics without a licensed pharmacist nor a prescription is justified as long as the self-
medicating buyer is initially educated by the storeowner about the drug. Moreover, this
supports the study done by Lansang (1991) that disclosed sari-sari stores as the
immediate source of antibiotics when the villagers are not able to travel to the city center.
Lansang added that self-medication is affected by external influence such as advice from
relatives, friends, traditional healers, or sales attendants at pharmacies.

Another surprising finding was that medical representatives roam around the area
to sell the medicines including antibiotics to them. This is an alarming discovery, as
medical representatives are prohibited from selling and administering drugs such as
antibiotics to unlicensed businesses outside of the healthcare industry. A box of
Cotrimoxazole for sale was even displayed publicly inside a vulcanizing shop in one of
the barangays.

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 Table 5. Sources where Antibiotics were Acquired
Percentage
Frequency Percentage (%) of Self-
Sources
(n=384) (%) Medicating
People (152)

Drugstores/Pharmacies 68 17.71% 44.74%

Community Health Centers 2 0.52% 1.32%

Barangay Health Center 28 7.29% 18.42%

Friends, Family, Co-workers 4 1.04% 2.63%

Leftover Medication 4 1.04% 2.63%

Sari-Sari Stores 73 19.01% 48.03%

others 12 3.13% 7.89%

Symptoms for which People Self-Medicated

When the respondents were asked about the symptoms or illnesses they were self-
medicating for, many of them confirmed that it was for toothache (64 or 42.11%). This is
reflected in Table 6 below.

Table 6. Symptoms that People Self-Medicated for

Percentage
Frequency Percentage (%) of Self-
Symptoms
(n=384) (%) Medicating
People (152)

Abdominal Pain 6 1.56% 3.95%

Cough 47 12.24% 30.92%

Fever 25 6.51% 16.45%

Headache 23 5.99% 15.13%

Nasal Congestion 5 1.30% 3.29%

Sore Eyes 3 0.78% 1.97%

Sore Throat 16 4.17% 10.53%

Wound 54 14.06% 35.53%

Toothache 64 16.67% 42.11%

others 27 7.03% 17.76%

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 Moreover, a significant number of the respondents reported wounds and cough as
among the main conditions that they treated with antibiotics without prescription.
Specifically, 54 or 35.53% said they used antibiotics to treat their wounds, and 25 or
16.45% of them self-medicated with antibiotics to treat cough.

Self-Medication as Rational Action

The results show that a significant number of self-medicating residents used used
antibiotics without prescription in order to avoid paying more for consultation fees and
avoid paying for expensive branded medicine that a doctor may potentially prescribe. The
inclination to self-medicate also appears to be motivated by the influence of family
members and by a prior experience with the use of antibiotics in treating similar
symptoms in the past. These behaviors and choices reflect cost-avoidance which is very
much consistent with the assumptions of rational choice theory. By-passing professional
medical consultation and relying instead on recommendations from family members and
on antecedent experiences to inform their decision to self-medicate may be construed as
‘satisficing’ behaviors. By self-medicating, people are still able to achieve their expected
utility, albeit only sub-optimally, without expending a lot of financial resources in the
process. The perfect scenario is that an individual achieves perfect utility by receiving
treatment for a symptom or illness. However, this is attained at a high cost - doctor’s fees,
cost of medicine, etc. Self-medicating individuals use antibiotics without prescription in
order to achieve treatment by saving money. It must be realized, however, that this
‘satisficing’ behavior comes at a great risk. In the absence of proper diagnosis and
prescription from a licensed physician, a self-medicating individual could end up treating
a wrong medical condition, or underusing or overusing a drug. This practice could
potentially contribute to the growing global trend of antimicrobial resistance.

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Conclusions

This study found that a significant portion of residents in Iloilo City self-
medicated with the use of antibiotics in the last twelve months. Specifically, 39.58% of
residents admitted to practicing self-medication. It was also revealed in the survey that
96.71% of these individuals used amoxicillin as a specific type of antibiotics used for
self-medication, and 28.95% used cefalexin. Also, 42.76% of them self-medicated with
antibiotics for about two to three times.
It is vital to note is that two in every five residents in Iloilo City purchased and
consumed antibiotics without the guidance of a licensed doctor/pharmacist. It is also vital
to note that two in every five of these self-medicating people did so for about two to three
times in the past year. A vast majority of them were found to have self-medicated with
the use of Amoxicillin as a specific type of antibiotic.
Furthermore, certain factors were found to have predisposed these people to self-
medicate. 62.50% of them used antibiotics without prescription in order to avoid paying
extra for doctor’s consultation fees, while 32.24% of them wanted to avoid the cost of
expensive branded medicine. Around 33.5% of these individuals admitted to being
influenced by family members to use antibiotics without a doctor’s prescription. It was
also found that 59.21% of them self-medicated with antibiotics because of an experience
with the use of antibiotics to treat prior similar symptoms.
Interestingly, 48.03% of self-medicating residents admitted that they acquired
their antibiotics from sari-sari stores, while 44.74% of them said they got it from
legitimate drug stores or pharmacies.
Finally, this study revealed that self-medicating residents of Iloilo City used
antibiotics in order to treat certain symptoms. About 42.22% of them used antibiotics in
order to treat toothache, while 35.53% used it for wounds, and 30.92% of them used
antibiotics for cough treatment.
In conclusion, a significant number of residents in Iloilo City self-medicated with
the use of antibiotics in the past twelve months and did so in order to avoid extra costs
associated with professional medical diagnosis and prescription. This raises concerns
about the widespread inappropriate use of antibiotics among residents in Iloilo City
which could lead to unintended consequences such as antimicrobial resistance.
Stricter implementation of the laws and regulations surrounding the distribution of
antibiotics among business establishments should be imposed, most especially legal
stipulations that prohibit the sale of prescription antibiotics and other prescription drugs
in sari-sari stores and other establishments that are not licensed and have no professional
medical supervision. Likewise, strict sanctions should be imposed among those who
distribute prescription antibiotics illegally. The government should strengthen its
campaign against antimicrobial resistance and raise awareness regarding proper usage of
antibiotics with particular focus on the adverse effects of antibiotic self-medication.

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Acknowledgments
The accomplishment of this research would not have been possible without the
people who have offered their generous support and guidance to us. Thus, we would like
to express our utmost gratitude and heartfelt appreciation to the following:

Mr. Rene Alvin F. Oquendo, our research adviser, for sharing his knowledge
and experience, and for providing us with his unwavering support, time, and energy.
Most especially for wholeheartedly guiding the researchers throughout the whole study.

Dr. Herman M. Lagon, Ateneo de Iloilo Senior High School Associate

Principal, for allowing the researchers to pursue the study despite the risks of this study.

Mr. Victor Erl R. dela Cruz V, our research subject teacher, for checking our
research paper and providing corrections.

Mr. Erlo Robert F. Oquendo, M.S. Comp. Sci. and Assistant Professor of
Statistics and Computer Science, UP Visayas, for validating our research instrument as
well as helping us interpret and analyze our data.

Our panelists, Mrs. Mary Jane P. Arenga, Mrs. Arianne Agnes V. Lao, Mr.
Edric Ancel P. Dueñas, Dr. Teila Matilda A. Posecion, and Professor Mary Ann
Naragdao, for validating our research instrument.

Ms. Rayellen M. Magallon, Ms. Maria Guzman, and Dr. Bernard Caspe, for
allowing us to conduct an interview with them so that we can gain information and gather
their insights on the topic of self-medication.

Mrs. Agnes Joy Salmon-Makilan, our school librarian, for assisting us in our
library work.

Mr. Alan Bautista, Villa Anita Barangay Kagawad, for helping the researchers in
conducting the survey in Villa Anita

Mr. Noel Aldwyn C. Abellar III, for assisting in the distribution, organization,
and analysis of survey questionnaires.

Our family, for providing us with their unwavering love and unending emotional
and financial support, for without them, the study would not have been possible.

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