Knowledge of potency and formulations of topical corticosteroids among drug vendors in the Federal Capital Territory of Nigeria

Abstract

Topical corticosteroids (TCs) are the most commonly prescribed medications in dermatology practice. Over-the-counter availability of all strengths in Nigeria has raised concerns regarding the use of TCs for non-labelled indications. Essentially, potential for misuse occurs at various levels, namely marketing, prescription, sales and end-use by patients and the lay public. This survey aims to determine the range of TCs available in drug outlets (i.e. pharmacies and drug shops) across the Federal Capital Territory (FCT) of Nigeria and to investigate the knowledge of the salesperson on their potency and formulation. A cross-sectional, questionnaire-based survey was conducted in drug outlets across the major satellite towns within the six area councils of the FCT from July to October 2017. The questionnaire sought to determine the brands of TCs available in pharmacies/drug shops, and obtain information on the knowledge of the potency and formulations of TCs by pharmacists/chemists. Data underwent descriptive statistical analysis. Of the 252 drug outlets visited, 174 (69%) met the inclusion criteria. Accurate knowledge of TC potency and formulations was obtained from 33.3% and 27.6% of the respondents, respectively. A total of 454 brands of TCs were on sale in 70.7% of these outlets. Over 73% were triple-combination creams (TC–antifungal–antibacterial combination); 5% and 5.5% were TC–antibacterials and TC–antifungal combinations, respectively, while 15% were TCs alone. Only 6.6% were mild-potency TCs and 98.6% were cream formulations. The majority of the respondents stated that some of the TC prescriptions were from doctors. Available TC formulations are skewed in favour of triple-combination creams. This is not in accordance with best clinical practice.