Abstract
Antibiotic resistance is a one of the major threats to public health worldwide. Over-the-counter dispensation and utilization of antibiotics are strongly linked with antibiotic resistance. Dispensing without prescription practice is widespread in most countries, including Pakistan. Generally the factors influencing the widespread supply of antibiotics without a prescription in Pakistan include lack of enforcement of laws, lack of knowledge of infectious diseases, patient pressure and socioeconomic factors of patients, the nature of pharmacy operations and monetary incentives from pharmaceutical companies. The objectives of this study were to evaluate the determinants of over-the-counter dispensation of antibiotics in the study area and recognize their motivations and the factors behind this practice. This cross-sectional study was conducted from July 2023 to November 2023 in 10 selected community pharmacies of District Tharparkar, Sindh Pakistan. The sample size calculated were 172 patients using Cochrane’s formula. The sampling technique was non-probability convenience. Out of 172 patients/attendants demanding antibiotics only 56 (33%) were with the prescriptions of a Registered Medical Practitioner while the remaining 116 (67%) were without the prescription. The 81 participants (70%) were unable to afford physicians' consulting charges, 21 participants (18%) had more trust in community pharmacies to suggest antibiotics as compared to physicians, 7 participants (6%) had no time for attending physician’s clinic and 7 participants (6%) were of the view that their consulting physician was not available in chamber/hospital. The top three antibiotics that were dispensed without prescription were metronidazole (75%), ciprofloxacin (15%) and amoxicillin (10%). Out of 10 community pharmacies, only one community pharmacy was run by the in-charge qualified pharmacist (10%) while the rest of the community pharmacies were run by non-pharmacists (90%). These findings emphasize the importance of implementing regulatory measures and enhancing public awareness, emphasizing the role of improved antimicrobial stewardship in restricting such practices
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