Antibiotic prescribing for upper respiratory tract infections by Libyan community pharmacists and medical practitioners: An observational study

Abstract

Background and Aims: Inappropriate uses of antibiotics for the treatment of common self-limiting infections are a major dispensing malpractice worldwide. This potentially may result in the development of resistant bacterial strains, which represents a significant public health problem. This study aimed to describe the pattern of antibiotics dispensing between community pharmacists (CPs) and general practitioners (GPs) regarding symptomatic diagnosis, antibiotic categories, and adherence to therapeutic doses. Subjects and Methods: Between March and June 2017, using trained simulated patients (SPs) with simulated clinical scenarios of having upper respiratory tract infections, a cross-sectional observational study of antibiotic dispensing encounters was conducted at 20 randomly selected pharmacies and clinics in the city of Tripoli, Libya. SPs were trained to deal with both expertise and record their notice after each visit in specific form developed by the researcher. The data were descriptively analyzed using Chi-square and Fisher's exact tests at alpha level of 0.05. Results: CPs dispensed more antibiotics than GPs (P = 0.001) for treating symptoms of common cold. They dispensed more amoxicillin (n = 32, 53.5%) than GPs (n = 18, 30.0%) (P = 0.001). While no CP dispensed ciprofloxacin, only two GPs dispensed this category (P = 0.022). In general, GPs comply better with the symptomatic diagnosis standard than CPs. On the other hand, CPs (n = 26, 59%) adhered better than GPs (n = 4, 12.5%) to therapeutic doses (P = 0.001). Conclusions: The findings suggested poor professional practices by both CPs and GPs. Antibiotic dispensing regulation policies need to be implemented in Libya and CPs must practice ethically.