Background: Self-medication with antibiotics is a global phenomenon and potentialcontributor to human pathogen resistance to antibiotics. Amongst Pakistanis, antibioticself-medication rates are high. At present, no data is available on prevalence and practicesof self-medication with antibiotics among Pakistani students abroad.

Aim: The aim of this study was to assess prevalence and comparative practices ofPakistani students in Sweden and Finland regarding self-medication with antibiotics.

Methods: The study used an anonymous cross-sectional Web-based questionnaire surveywith convenience census sampling targeted to Pakistani students in Sweden and Finland.Questionnaire asking use of antibiotics and six-month recall of antibiotic self-medicationbefore the survey was administered to the 9333 potential respondents. Data was analyzedusing statistical software R version 2.8.1. Descriptive statistic was used to analyze theresults. Associations were tested using Pearson's Chi-squared test.

Findings: Response rate was 2.3% after five reminders. Of 213 participants (mean age27.9 years), 151 were from Sweden and 57 were from Finland. One hundred eleven(52.1%) reported antibiotic self-medication in their life time and forty two percent knewthat it could be injurious to health. Sixty-eight participants (31.9%) did self-medicationwith antibiotics during their stay in the study countries and almost all used oral antibiotics.Unrestricted pharmacy sale was the commonest source (37%) of such antibiotics.Common symptoms triggering antibiotic self-medication were respiratory (42.6%) andoro-dental (13.2%). Preferred antibiotics were broad spectrum Penicillin (41.2%),Macrolides (23.5%) and Quinolones (6.2%). Almost all (98.8%) antibiotics for suchmedication were obtained from Pakistan. About 27% reported that they would considerself-medication with antibiotics in future. The most common reason for antibiotic selfmedicationwas affordability of health care consultation and antibiotics (23.9%). Therewas no significant difference between the self-medication practices of participants basedon country of studentship (p=0.6). Self-medication rates were not significantly lower instudents who were aware that it may harm (p=0.2) and is unsafe (p=0.2).

Conclusion: High prevalence of self-medication with antibiotics among participants is amatter of concern from individual and public health perspective. There is need to augmentawareness and implement legislations to promote judicious and safe practices. Furtherstudies are needed concerning resistance impact of antibiotic self-medication.

Key wards: self-medication, antibiotics, Pakistani students, abroad, practices