Decrease in Antibiotic Sales in Brazil After New Control Legislation

Abstract

Abstract Background Brazil, like many Latin American countries, has struggled with the inappropriate use of antibiotics in the community without a prescription form a physician. Since November 2010, The Brazilian Health Surveillance Agency has established stricter control of antibiotic sales, which requires that a copy of antibiotic prescriptions be retained by the pharmacy for audit. Pharmacists now also have more severe civil and criminal liability if they allow the sale of antibiotics without a prescription. The aim of this study was to analyze the impact of the new legislation preventing the sale of antibiotics in pharmacies without a prescription. Methods The data for antibiotic usage in units was collected from electronic monitoring of pharmacy members of the Brazilian Federation of Pharmacies (FEBRAFAR), which tracked information about the antibiotics sold in approximately 3,000 pharmacies from 1,500 municipalities across Brazil. We compared the sale of antibiotics during two time periods: 12 months prior to the new legislation and 12 months after. Results We observed a reduction in pharmacy sales of each class of antibiotics included in this study following the implementation of the new legislation. Pharmacy sales for 27 (84.4%) of the 32 antibiotics included in the study were reduced in response to the new legislation, whereas sales of five antibiotics were increased. Overall, tetracycline (−57.8%), co-trimoxazole (−28.8%), and amoxicillin (−29.1%) showed the largest reduction of all agents. With month to month analysis, the greatest reduction in units sold/month was observed for the following therapeutic classes: tetracyclines (30.5%), sulfonamides (28.5%), macrolides (25.0%), and penicillins (20.5%). Yearly trend analysis showed a significant reduction in antibiotics during the winter months (average monthly difference: −31.5%, P < 0.05) Conclusion The reduction in the number of antibiotic units sold by pharmacies after the implementation of legislation designed to regulate antibiotic use in Brazil suggests that the policy is successful and will contribute to rational use of antibiotics in Brazil. Disclosures All authors: No reported disclosures.