Factors Related to Antibiotic Supply without a Prescription for Common Infections: A Cross-Sectional National Survey in Sri Lanka.

Shukry Zawahir,Parisa Aslani,Sarath Lekamwasam

doi:10.3390/antibiotics10060647

Shukry Zawahir, Parisa Aslani + Show 1 more

Open Access

https://doi.org/10.3390/antibiotics10060647

Copy DOI

Journal: Antibiotics	Publication Date: May 28, 2021
Citations: 8	License type: CC BY 4.0

Affiliation: University of Sydney, University of Ruhuna

Abstract

Inappropriate antibiotic use is a problem in Sri Lanka. We investigated pharmacy staff’s attitudes towards antibiotic supply for common infections in Sri Lanka. A self-reported cross-sectional survey was conducted among a random sample (n = 369) of pharmacies. We assessed staff’s beliefs and attitudes to antibiotic supplying for common infections (common cold and cough, sore throat, diarrhoea, wound and urinary tract infections (UTI)). Pharmacists (n = 210; 79%) and pharmacy assistants (n = 55: 21%) responded. About 30% (80/265) had supplied antibiotics without a prescription for common infections, including common cold (15.8%), sore throat (13.6%) and diarrhoea (10.2%). Overall, pharmacists were less likely to supply than non-pharmacists. Pharmacy staff with more positive beliefs about their professional competency to supply and monitor antibiotic use were more likely to supply antibiotics without a prescription for common cold (Adj.OR = 1.08; 95% CI: 1.01–1.15; p = 0.032), wound infections (Adj. OR = 1.06; 95% CI: 1.00–1.13; p = 0.059), and UTI (Adj.OR = 1.07; 95% CI: 0.99–1.15; p = 0.097). Pharmacy staff who believed in the effectiveness of antibiotics against common infections were more likely to supply antibiotics for common infections. Supply of antibiotics without a prescription was associated with staff’s beliefs about antibiotics’ effectiveness and their professional competency. Our findings could be used to strengthen regulatory strategies to improve practice.

Highlights

Antibiotic consumption has increased by 35% between 2000 and 2010 [1]
Whilst our findings demonstrated that supply of antibiotics without a prescription from community pharmacies for common infections is widespread in Sri Lanka, these figures are lower when compared to our mystery shopper visits to the same pharmacies
The findings of this study have identified a need for interventions to improve pharmacists’ and pharmacy staff’s knowledge related to appropriate antibiotic use and supply, and influence their beliefs about antibiotics and possibly behaviour

Summary

Introduction

Antibiotic consumption has increased by 35% between 2000 and 2010 [1]. The rate of antibiotic consumption correlates closely with the emergence of antibiotic resistance (ABR), in both hospital and outpatient settings [2,3]. Inappropriate antibiotic use is a major driver of ABR, increasing morbidity, mortality, and unnecessary healthcare costs [4,5], and representing one of the most important threats to global public health and patient safety [6,7]. This has led the WHO to develop a global action plan which includes a range of activities to raise awareness of the importance of protecting the efficacy of antibiotics and reducing inappropriate antibiotic use [8]. Despite the fact that antibiotics cannot treat infections caused by viruses such as common cold, acute sore throat, runny nose and flu [13,14,15,16], the majority of respondents (76%) in the Sri Lankan study had used antibiotics inappropriately for these minor infections [12]

Objectives

Methods

Results

Discussion

Conclusion