Dispensing Antibiotics without a Prescription for Acute Cough Associated with Common Cold at Community Pharmacies in Shenyang, Northeastern China: A Cross-Sectional Study.

Li Shi,Shuchen Hu,Panpan Zhai,Khezar Hayat,Mingyue Zhao,Zhitong Feng,Pengchao Li,Minghuan Jiang,John Alimamy Kabba,Jie Chang,Caijun Yang,Hao Hu,Xiaoxi Liu,Yu Fang

doi:10.3390/antibiotics9040163

Abstract

The inappropriate use of antibiotics is a major health issue in China. We aimed to assess nonprescription antibiotic dispensing and assess pharmacy service practice at community pharmacies in Shenyang, northeastern China, and to compare these practices between pediatric and adult cases. A cross-sectional study was performed from March to May 2018 using the standardized client method. Two different simulated scenarios were presented at pharmacies, namely, pediatric and adult acute cough associated with a common cold. Of 150 pharmacy visits, 147 visits were completed (pediatric case: 73, adult case: 74). A total of 130 (88.4%) community pharmacies dispensed antibiotics without a prescription, with a significant difference between pediatric and adult cases (pediatric case, 79.5% versus adult case, 97.3%, p = 0.005). Symptoms were asked in most visits (pediatric case: 82.2%, adult case 82.4%). Patients’ previous treatment and history of allergies were both inquired more frequently in the pediatric cases than in the adult cases. Medication advice was provided more often in the adult cases than in pediatric cases. Antibiotics were easily obtained without a prescription in Shenyang, especially for adult patients. Adequate inquiries and counseling had not occurred in most pharmacies.

Highlights

Antimicrobial resistance (AMR) has become a global health crisis [1]
Visits based on the pediatric cases, and visits based on the adult cases were completed
After the multivariate binary logistic regressions, it was found that nonprescription antibiotics are less likely to be dispensed for a child with acute cough odds ratios (OR) = 0.099, 95% confidence interval (CI) 0.020–0.505, p = 0.005

Summary

Introduction

Organization (WHO) emphasized that AMR has severe effects on health and the economy, and the inappropriate use of antibiotics stimulated and accelerated the process of AMR [2]. Inappropriate use of antibiotics in China is a serious issue. China is one of the world’s largest producers and consumers of antibiotics. Antibiotics are widely used for disease treatment in humans and animals [3]. In 2013, 92,700 metric tons of antibiotics were consumed in China, 48% of which were consumed by humans, with the remaining consumed by animals. These usage estimates exceed the use in the UK and much of northern Europe [4].

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Discussion

Conclusion