Abstract
Aim: In Belize, antibiotics are categorized as prescription-only drugs, and their sales over the counter without a prescription is prohibited. This study assessed the sales and dispensing of antibiotics in community pharmacies without a prescription. Methods: 36 community pharmacies in 4 districts of Belize were assessed for non-prescription sales of antibiotics using a simulated client method (SCM) approach from September to November 2019. Results: The majority (19; 52.8%) of the community pharmacies assessed refused to sell antibiotics without a prescription from a physician. Approximately 17 (47.2%) sold and dispensed antibiotics to simulated clients (SCs) without a prescription. Adequate patient counseling was provided by the pharmacists to the SCs. Conclusion: Some level of lack of compliance with the sales of antibiotics without prescription was observed among community pharmacists in this study. There is a need to reinforce stricter control on the sales and dispensing of antibiotics without prescription in the country of Belize.
Highlights
The Belize Antibiotic Act prohibits the sales of antibiotics to any person except on the prescription of a medical practitioner, dentist, or veterinary surgeon
Metronidazole (60%) was the main antibiotic sold over the counter for gastrointestinal tract infection (GIT) scenarios (Table 3)
Amoxicillin was dispensed for both urinary tract infection (UTI) (33.3%) and respiratory tract scenarios (33.3%)
Summary
The Belize Antibiotic Act (revised edition 2000) prohibits the sales of antibiotics to any person except on the prescription of a medical practitioner, dentist, or veterinary surgeon. The enforcement of this law has been very challenging for the Belize Ministry of Health due to insufficient human and financial resources and logistics [1]. The center for Disease Control and Prevention (CDC) reported that at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die each year in the USA, making antibiotic resistance a major global health challenge [3]. In the case of Belize, weak regulatory enforcement due to limited human and financial resources has been reported as major challenges for the enforcement of the Antibiotics acts [1]. Economic gain and the desire by the pharmacists to meet client demands may be some of the reasons why some community pharmacists continue to sell antibiotics without prescription, thereby contravening the law prohibiting such practices
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