Self-medication with antibiotics in Ecuador and Latin America: magnitude, determinants, and proposals for intervention
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Antibiotic self-medication remains one of the most widespread and concerning public health issues, particularly in Latin America, where easy access to antimicrobials and barriers to healthcare have fostered their irrational use. This descriptive review synthesizes scientific evidence published between 2010 and 2025 on antibiotic self-medication in Ecuador and Latin America, drawing from international databases and official health organizations. The analyzed studies reveal high prevalence rates ranging from 46% to 65% in countries such as Ecuador, Peru, and Colombia. The most frequent determinants include low knowledge about antibiotics, non-prescription sales, socioeconomic barriers and limited access to medical care, as well as influence from pharmacists or family members. The COVID-19 pandemic exacerbated this phenomenon, promoting empirical use of antibiotics like azithromycin and amoxicillin without medical justification. Reported interventions emphasize the effectiveness of strict regulation of antibiotic dispensing, continuous public education, and the proactive role of pharmacists in promoting responsible use. Overall, antibiotic self-medication in Ecuador and Latin America represents a persistent, multifactorial challenge that significantly contributes to antimicrobial resistance and requires coordinated strategies integrating regulation, education, surveillance, and improved access to healthcare services.
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