Over-the-counter sales of drugs used as second-line therapy for tuberculosis in different parts of the world: a review

Abstract

The increasing burden of drug-resistant tuberculosis (TB) is a major public health concern, and effective strategies need to be planned to prevent its emergence and transmission. Private healthcare centres and pharmacies are the first point of healthcare access in many low- and middle-income countries. The prevalence of resistance to second-line anti-TB drugs, especially fluoroquinolones, is high in some countries with a high TB burden. In these countries, second-line anti-TB drugs, such as fluoroquinolones, amoxicillin–clavulanate and injectable agents such as amikacin, are often available as over-the-counter drugs, often taken as self-medication and used for other indications. Stringent policies and effective implementation need to be in place for preventing the inappropriate use of these drugs to prevent the emergence of drug resistance.