Abstract
It is well known that the emergence of antibiotic resistance is linked to the misuse and overuse of antibiotics. Misuse includes self-medication and the inappropriate use of antibiotics because of improper dosage or improper duration than recommended. This study investigated three patterns of dispensing antibiotics in a sample of community pharmacies in Jordan. This included dispensing antibiotics by prescription or over-the-counter either by direct request or upon a pharmacist’s recommendation. The antibiotics dispensed were evaluated in terms of indication, appropriateness of dose, and duration of treatment based on the empirical treatment suggested by selected references: Lexicomp (2017) and UptoDate (2017) and the manufacturer’s recommendations. Of the 457 antibiotics dispensed, almost one third were without prescription. Of the antibiotics dispensed with prescription or without prescription, 31.5% and 24.6% respectively were appropriate dosage and duration (p = 0.002). In the three patterns of dispensing, beta lactam antibiotics were the most commonly dispensed. In addition, it was noticed that there was a tendency to prescribe or dispense higher generations of antibiotics to cases that could have been treated with lower generation or safer antibiotics. Furthermore, 12.2% of the antibiotics were dispensed to treat infections that are not indicated for them. In conclusion, a significant proportion of antibiotics are dispensed without prescription in Jordan. Moreover, a considerable proportion of prescribed antibiotics were inappropriate for the conditions concerned. This indicates the importance of enforcing the Jordanian regulations prohibiting the dispensing of nonprescription antibiotics and the implementation of continuous education to physicians and pharmacists to increase awareness about the emergence of antibiotic resistance.
Highlights
Antibiotic resistance is among the biggest threats to global health
Dispensing practices related to antibiotics were assessed over a period of four months
More than half of the patients (53.7%) for whom antibiotics were requested were in the age range 19–45 years
Summary
Antibiotic resistance is among the biggest threats to global health. It is rising to more dangerous levels worldwide. Antibiotic dispensing practice in community pharmacies in Jordan addressed its concerns about running out of antibiotic options to treat some resistant bacterial infections [1]. It is well known that antibiotic resistance occurs as a natural process at low rates [2]. The misuse or irrational use of antibiotics in humans accelerates the emergence and spread of the process [3]. Irrational use includes the use of antibiotics to treat viral infections, negligent use, or the wrong drug or inappropriate dosage or duration for treatment [3,4,5]
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