Pharmacy approach to a case of acute diarrhoea with dehydration in Antalya, Turkey

Abstract

A study examining the approach of pharmacies to diarrhoeal disease in childhood was carried out in Antalya, Turkey. A fictitious case history of a 10 month infant with an acute diarrhoea of three days duration, which was clinically identical with viral diarrhoea and accompanied by moderate dehydration was hypothesised. Following this, final semester students of the medical faculty posed as relatives of the infant and sought the advice of pharmacy attendants. The approach, to this hypothesised case, of all 214 pharmacies in the Antalya municipality district was examined. Most of the pharmacy attendants (57.7%) did not ask any questions to determine a differential diagnosis or establish the degree of dehydration. Only 21.6% of the pharmacy attendants recommended consulting a doctor or health centre, 6.5% recommended Oral Rehydration Solution (ORS) without giving an explanation about the amount needed or for how long it should be administered, 44.4% only dispensed a drug, 23.8% dispensed a drug with ORS and 3.7% recommended infant formula. Antidiarrhoeals were dispensed by 67.2% of the pharmacies and 14% gave antibiotics. Also 5.6% of the pharmacy attendants advised a reduction in the infant's fluid intake, 17.3% said that they could not give an opinion regarding breast feeding 19.2% advised stopping breast feeding and 7.0% did not know. All the pharmacies except the ones with the appropriate recommendation ‘consult a doctor or a health centre’ responded with advice given without hesitation although they did not intend to inspect or examine the infant. The approaches for acute diarrhoea of the pharmacies were determined as inappropriate and harmful.