Objective  To explore the prevalence of chronic obstructive pulmonary disease (COPD), knowledge about antibiotics and their influences on self-medication with antibiotics (SMA) among middle-aged and elderly adults in communities of Songjiang district, Shanghai city.

  Methods  The participants of the survey were 3 500 residents aged 40 years and over recruited using random sampling at four communities in Songjiang district of Shanghai city. Face-to-face interview with a self-designed questionnaire and Pittsburgh Sleep Quality Index (PSQI), physical examination and spirometry test were conducted among the participants during June – December 2021. Unconditional multivariate logistic regression model was adopted to analyze the influences of COPD, knowledge and awareness about antibiotics on SMA.

  Results   Of the 3 184 participants ultimately included in the analysis, 259 (8.1%) were identified as having COPD. The number (proportion) of the participants with the antibiotic awareness score of 0, 1, 2, and 3 – 4 (indicating complete awareness) were 969 (30.4%), 461 (14.5%), 1462 (45.9%), and 292 (9.2%), respectively. The number (proportion) of the participants reporting SMA was 537 (16.9%). The results of unconditional multivariate logistic regression analysis showed that compared to the participants without COPD, the COPD sufferers aged under 60 years had a significantly increased risk of SMA (odds ratio OR = 3.31, 95% confidence interval 95% CI: 1.11 – 9.90) after adjusting for sex, education level, marital status, place of residence, smoking, exercise, sleeping status, digestive system disease, other respiratory system diseases, cough and sputum symptoms, shortness of breath symptoms, and body mass index; but the increased risk was not significant for the COPD sufferers aged ≥ 60 years (OR = 1.09, 95% CI: 0.74 – 1.60); the results also revealed that in comparison to those with the antibiotic knowledge and awareness score of 0, the participants with the knowledge and awareness scores of 1, 2, and 3 – 4 were less likely to conduct SMA, with the ORs (95% CI) of 0.26 (0.18 – 0.36), 0.17 (0.13 – 0.22), and 0.17 (0.10 to 0.26) after adjusting for age and the confounding factors mentioned above.

  Conclusion  The prevalence of SMA was high and the prevalence might be associated positively with suffering with COPD and reversely with the awareness about antibiotics among middle-aged and elderly community adults in Songjiang district, Shanghai.