Explore the vast range of titles available.

Background Antibiotic resistance presents a substantial threat to global public health. One of the primary contributors to antibiotic resistance is the irrational use of antibiotics. This study aimed to comprehensively assess the prevalence and associated factors of antibiotic self-medication (ASM) practices among the pediatric population in India. Methods A comprehensive search was conducted in PubMed, Embase, Scopus, and Google Scholar to identify relevant articles published up to December 2024. Inclusion criteria included studies reporting the prevalence rate of ASM practices among the pediatric population in India. Quality assessment of the included studies was conducted using the JBI tool for prevalence studies. Data were extracted using a standardized form and analyzed using R software with a random-effects model. Results Seventeen studies involving 7847 children were analyzed. The pooled prevalence of pediatric ASM in India was 19.8% (95% CI: 13.5; 28.2; I 2  = 98.2%; p  < 0.01). Regional disparities were observed ( p  < 0.01), with the northern region exhibiting the highest prevalence at 30.7%. No significant difference in prevalence was found between studies that recruited participants from hospital and community settings ( p  = 0.0552). Key factors associated with pediatric ASM included financial constraints, time constraints, perceptions of mild illness, and limited healthcare access. Common sources for procuring antibiotics were local pharmacies, leftover medications, and friends/family members. Information sources regarding the use of antibiotics included previous prescriptions, friends/family members, media, past experiences, and pharmacists. The mean duration of antibiotic consumption was 2.5 days. Conclusion Self-medication with antibiotics was prevalent among the pediatric population in India. Therefore, government and policymakers should take necessary measures to promote the responsible use of antibiotics. Highlights The prevalence of antibiotic self-medication among children in India was 19.8%. Significant regional differences were observed, with the highest prevalence in North region. Financial constraints, time limitations, and the perception of mild illness were main reasons. Antibiotics were mainly sourced from pharmacies, leftover medicines, and family/friends. Urgent measures are needed to promote the responsible use of antibiotics in children. Graphical Abstract