One of the most significant health challenges that has emerged in the 21st century is antimicrobial resistance (AMR) (Littmann & Viens, 2015). This problem is an increasing one, with evidence of significant resistance among anaerobic bacteria increasing globally (Schuetz, 2014). The primary cause of AMR is over-exposure to antibiotics and other antimicrobial agents such as penicillin. Some of this problem has been attributed to poor management or stewardship of antimicrobial use on the part of physicians (Parker & Mattick, 2016). However, there are other factors which contribute to this phenomenon. According to the World Health Organization (WHO) (2001), patient-related factors such as self-medicating with antibiotics have also shown a demonstrable impact on the increase of antimicrobial resistance.

Self-medication with antibiotics/antimicrobials occurs when an individual obtains antibiotics, usually illegally, to treat infection (WHO, 2001), or what they perceive to be an infection. The illegal aspect of this transaction is particularly troubling, since the majority of antibiotic agents are prescription-only (WHO, 2001). Beyond the issue of illegally obtaining prescription-only medications, there are other problems associated with self-medicating with antibiotics. These include whether or not the individual has an illness that can actually be treated using antibiotics; whether or not the individual is taking the proper dose; and whether or not the drug is actually contains sufficient amounts of the active ingredient (WHO, 2001). There is even the question of safety; the drug may not contain safe amounts of the active agent.

The individual could have obtained counterfeit drugs (WHO, 2001). Self-medication is, like AMR, a global issue, and affects many different populations of people. Of particular importance to this research are college students, with this problem affecting students from China to Libya and countries in between, in both medical and non-medical disciplines (Shah et al., 2015).