Prevalence and Determinants of Antibiotic Use by the Elderly in Marrakech, Morocco

Abstract

Antibiotics are essential for the prevention and treatment of bacterial infections; however, their inappropriate use among elderly populations poses serious risks, including the emergence of multidrug-resistant organisms. Antimicrobial resistance has become a critical global public health challenge, with irrational antibiotic use being one of its primary drivers. In Morocco, data on antibiotic use among older adults remain scarce, particularly regarding the determinants of irrational use in this vulnerable group, a gap that hinders the development of targeted health policies. This cross-sectional study aimed to assess the prevalence of antibiotic use among elderly individuals in Marrakech and to identify the key determinants of irrational use. Participants were recruited from primary healthcare centers and pharmacies in the city of Marrakech using stratified sampling. A total of 180 elderly individuals with prior awareness of antibiotics were enrolled, of whom 144 completed questionnaires were included in the final analysis. Logistic regression was performed to identify factors associated with antibiotic use patterns. Among respondents, 62.5% had used antibiotics in the 12 months preceding the survey, and only 46.8% had adhered to their prescribed antibiotic course. Self-medication was reported in 36.7% of cases, with leftover medicines (20%) and over-the-counter pharmacy purchases (16.7%) as the primary sources. Respiratory infections were the most common indication for antibiotic use (30%). Multivariable logistic regression revealed that urban origin was associated with better antibiotic knowledge, female sex with better practice, and rural origin, nuclear family structure, and higher educational level with more appropriate antibiotic-related behaviour. These findings highlight significant gaps in antibiotic knowledge and adherence among the elderly in Marrakech. Strengthened public health education and stricter regulation of antibiotic dispensing are urgently needed to curb irrational antibiotic use in this population.