Abstract
Community pharmacies are the main channel of antibiotics distribution. We aimed to analyze the dispensing of non-prescribed antibiotics and knowledge of pharmacy staff. We conducted a cross-sectional study in Punjab, Pakistan between December 2017 and March 2018. A self-administered, structured, pretested, and validated bilingual questionnaire was used, and we used chi-square tests in the statistical analysis. A total of 573 (91.7%) pharmacy retailers responded to the survey; 44.0% were aged 31–40 years and all were men. Approximately 81.5% of participants declared that dispensing non-prescribed antibiotics is a common practice in community pharmacies, and 51.1% considered themselves to be authorized to dispense these drugs; 69.3% believed this a contributing factor to antimicrobial resistance. Most (79.1%) respondents believed that this practice promotes irrational antibiotics use, and half (52.2%) considered antimicrobial resistance to be a public health issue. Only 34.5% of respondents reported recommending that patients consult with a doctor prior to using antibiotics, and 61.8% perceived that their dispensing practices reduce patients’ economic burden. Approximately 44.9% of pharmacy retailers stated that they have proper knowledge about antibiotics use. Nitroimidazole was the main class of antibiotic dispensed without a prescription. Dispensing of injectable and broad-spectrum antibiotics can be potential threat for infection cure. Poor knowledge of staff is associated with dispensing of non-prescribed antibiotics. This inappropriate practice must be addressed immediately.
Highlights
Community pharmacies are consideredas a main source of antibiotics’ distribution, worldwide [1]
Most pharmacy retailers (81.5%) had a non-professional education; approximately half (51.3%) had working experience of more than 10 years, and half (51.3%) declared their status was an employee of the pharmacy
Similar to other countries with developing health care systems [1,2,4,22,23,24,25], the current study revealed the high incidence of Dispensing of non-prescribed antibiotics (DoNA) in community pharmacies
Summary
Community pharmacies are consideredas a main source of antibiotics’ distribution, worldwide [1]. Dispensing of non-prescribed antibiotics (DoNA) through these channels is a common phenomenon [2,3,4,5,6,7,8]. DoNA promotes irrational medication in the community [3,4]. The World Health Organization reports that unnecessary and inappropriate medication with antibiotics is amplifying antimicrobial resistance (AMR) [5]. Pakistan has a high AMR owing to extensive misuse of antibiotics [6]. Extensively drug-resistant typhoid fever has created an epidemic situation in Pakistan [6,7]. Multidrug resistance is high in the country (>25–100%), and AMR is increasing owing to increased sales of antibiotics [8]
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