Determinants of dispensing antibiotics without prescription by community pharmacists in developing countries: A review

Teressa Andrea Esteves Gabriel Jay Atabay Elizabeth Yu Tan   

Open Access   

Published:  Feb 25, 2023

DOI: 10.7324/JAPS.2023.52735
Abstract

Developing countries are more vulnerable to antibiotic resistance and pose the greatest threat to public health globally than developed countries due to complex issues about the nature of their healthcare system as well as other patient-related factors. Inappropriate antibiotic drug use and their unrestricted availability in community pharmacies and other retail establishments can contribute to this issue. The research provides a review of scholarly literature to identify what possible determinants could contribute to inappropriate antibiotic dispensing practices. Most studies in this review have indicated that lack of knowledge among community pharmacists and lax law enforcement, from intrinsic and extrinsic factors, respectively, were the most frequent aspects associated with antibiotic dispensing with no prescription; thus, measures to be taken to counteract or reduce these determinants should be considered. In this case, intervention should be made locally, along with coordination among health authorities and other healthcare providers.


Keyword:      Antibiotics dispensing community pharmacy antimicrobial resistance pharmacists


Citation:

Esteves TA, Atabay GJ, Tan EY. Determinants of dispensing antibiotics without prescription by community pharmacists in developing countries: A review. J Appl Pharm Sci, 2023. https://doi.org/10.7324/JAPS.2023.52735

Copyright: © The Author(s). This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

HTML Full Text

Reference

Abdelaziz A, Tawfik A, Rabie K, Omran M, Hussein M, Abou- Ali A, Ahmed A. Quality of community pharmacy practice in antibiotic self-medication encounters: a simulated patient study in Upper Egypt. Antibiotics, 2019; 8(2):35. https://doi.org/10.3390/antibiotics8020035

Abubakar U, Tangiisuran B. Knowledge and practices of community harmacists towards non-prescription dispensing of antibiotics in northern Nigeria. Int J Clin Pharm, 2020; 42(2):756-64. https://doi.org/10.1007/s11096-020-01019-y

Akbar Z, Saleem Z, Shaukat A, Farrukh MJ. Perception and practice of community pharmacist towards antimicrobial stewardship in Lahore, Pakistan. J Glob Antimicrob Resist, 2021; 25:157-61. https://doi.org/10.1016/j.jgar.2021.03.013

Alhomoud F, Almahasnah R, Alhomoud FK. "You could lose when you misuse" - factors affecting over-the-counter sale of antibiotics in community pharmacies in Saudi Arabia: a qualitative study. BioMed Central, 2018; 18(1):915. https://doi.org/10.1186/s12913-018-3753-y

Alkadhimi A, Dawood OT, Hassali MA. Dispensing of antibiotics in community pharmacy in Iraq: a qualitative study. Pharm Pract, 2020; 18(4):2095. https://doi.org/10.18549/PharmPract.2020.4.2095

Al-Mohamadi A, Badr A, Bin Mahfouz L, Samargandi D, Al Ahdal A. Dispensing medications without prescription at Saudi community pharmacy: extent and perception. SPJ, 2013; 21(1):13-8. https://doi.org/10.1016/j.jsps.2011.11.003

American Society of Health System Pharmacists. ASHP statement on the pharmacist's role in antimicrobial stewardship and infection prevention and control. Am J Health Syst Pharm, 2010; 67(7):575-7. https://doi.org/10.2146/sp100001

Ayukekbong JA, Ntemgwa M, Atabe AN. The threat of antimicrobial resistance in developing countries: causes and control strategies. Antimicrob Resist Infect Control, 2017; 6(1):47. https://doi.org/10.1186/s13756-017-0208-x

Bahta M, Tesfamariam S, Weldemariam DG, Yemane H, Tesfamariam EH, Alem T, Russom M. Dispensing of antibiotics without prescription and associated factors in drug retail outlets of Eritrea: a simulated client method. PLoS One, 2020; 15(1):e0228013. https://doi.org/10.1371/journal.pone.0228013

Barker AK, Brown K, Ahsan M, Sengupta S, Safdar N. What drives inappropriate antibiotic dispensing? A mixed-methods study of pharmacy employee perspectives in Haryana, India. BMJ Open, 2017; 7(3):e013190; doi:10.1136/bmjopen-2016-013190. https://doi.org/10.1136/bmjopen-2016-013190

Belachew S, Hall L, Selvey LA. Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis. Antimicrob Resist Infect Control, 2021; 10(1):13. https://doi.org/10.1186/s13756-020-00880-w

Bin Abdulhak AA, Altannir MA, Almansor MA, Almohaya MS, Onazi AS, Marei MA, Aldossary OF, Obeidat SA, Obeidat MA, Riaz MS, Tleyjeh IM. Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: a cross sectional study. BMC Public Health, 2011; 11(1); doi:10.1186/1471-2458-11-538. https://doi.org/10.1186/1471-2458-11-538

Cars O, Nordberg P. Antibiotic resistance-the faceless threat. Int J Risk Saf Med, 2005; 17:103-10.

Chang J, Xu S, Zhu S, Li Z, Yu J, Zhang Y, Zu J, Fang Y, Ross-Degnan D. Assessment of non-prescription antibiotic dispensing at community pharmacies in China with simulated clients: a mixed cross-sectional and longitudinal study. Lancet Infect Dis, 2019; 19:1345-54; doi:10.1016/S1473-3099(19)30324-X. https://doi.org/10.1016/S1473-3099(19)30324-X

Darj E, Newaz MS, Zaman MH. Pharmacists' perception of their challenges at work, focusing on antimicrobial resistance: a qualitative study from Bangladesh. Glob Health Action, 2019; 12(sup1):1735126; doi:10.10 80/16549716.2020.1735126. https://doi.org/10.1080/16549716.2020.1735126

Dillip A, Embrey M, Shekalaghe E, Ross-Degnan D, Vialle- Valentin C, Kimatta S, Liana J, Rutta E, Valimba R, Chalker J. What motivates antibiotic dispensing in accredited drug dispensing outlets in Tanzania? A qualitative study. Antimicrob Resist Infect Control, 2015; 4(1):30. https://doi.org/10.1186/s13756-015-0073-4

Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open, 2016; 6(12):e011458; doi:10.1136/ bmjopen-2016-011458 https://doi.org/10.1136/bmjopen-2016-011458

Farah R, Lahoud N, Salameh P, Saleh N. Antibiotic dispensation by Lebanese pharmacists: a comparison of higher and lower socio-economic levels. J Infect Public Health, 2015; 8(1):37-46. https://doi.org/10.1016/j.jiph.2014.07.003

Fathalla MF, Fathalla MMF. Sexual and reproductive health: overview. In: Heggenhougen HK (ed.). International encyclopedia of public health, Elsevier, Amsterdam, The Netherlands, pp 695-705, 2008. https://doi.org/10.1016/B978-012373960-5.00465-2

Gong Y, Jiang N, Chen Z, Wang J, Zhang J, Feng J, Lu Z, Yin X. Over- the-counter antibiotic sales in community and online pharmacies, China. Bull World Health Organ, 2020; 98(7):449-57; doi:10.2471/ BLT.19.242370. https://doi.org/10.2471/BLT.19.242370

Haddadin RN, Alsous M, Wazaify M, Tahaineh L. Evaluation of antibiotic dispensing practice in community pharmacies in Jordan: a cross sectional study. PLoS One, 2019; 14(4):e0216115. https://doi.org/10.1371/journal.pone.0216115

Hadi MA, Karami NA, Al-Muwalid AS, Al-Otabi A, Al-Subahi E, Bamomen A, Mohamed M, Elrggal M. Community pharmacists' knowledge, attitude, and practices towards dispensing antibiotics without prescription (DAwP): a cross-sectional survey in Makkah Province, Saudi Arabia. Int J Infect Dis, 2016; 47:95-100. https://doi.org/10.1016/j.ijid.2016.06.003

Homedes N, Ugalde A. Mexican pharmacies: benefits and risks for border residents in the United States of America and Mexico. Rev Panam de Salud Pública, 2013; 33(3):196-204. https://doi.org/10.1590/S1020-49892013000300006

Hoxha I, Malaj A, Kraja B, Bino S, Oluka M, Markovi?- Pekovi? V, Godman B. Are pharmacists' good knowledge and awareness on antibiotics taken for granted? The situation in Albania and future implications across countries. J Glob Antimicrob Resist, 2018; 13:240-5; doi: 10.1016/j.jgar.2018.01.019. https://doi.org/10.1016/j.jgar.2018.01.019

Khan MU, Hassali MA, Ahmad A, Elkalmi RM, Zaidi S, Dhingra S. Perceptions and practices of community pharmacists towards antimicrobial stewardship in the state of Selangor, Malaysia. PLoS One, 2016; 11(2):e0149623. https://doi.org/10.1371/journal.pone.0149623

Kotwani A, Wattal C, Joshi PC, Holloway K. Irrational use of antibiotics and role of the pharmacist: an insight from a qualitative study in New Delhi, India. J Clin Pharm Ther, 2011; 37(3):308-12. https://doi.org/10.1111/j.1365-2710.2011.01293.x

Kuepper J. What is a developing country? [document on the Internet]. The Balance, New York, NY, 2020. Available via https://www. thebalance.com/what-is-a-developing-country-1978982 (Accessed 6 January 2022)

Long HA, French DP, Brooks JM. Optimising the value of the critical appraisal skills programme (CASP) tool for quality appraisal in qualitative evidence synthesis. Res Methods Med Health Sci, 2020; 1(1):31-42; doi:10.1177/2632084320947559 https://doi.org/10.1177/2632084320947559

Mahmoud MA, Aldhaeefi M, Sheikh A, Aljadhey H. Community pharmacists perspectives about reasons behind antibiotics dispensing without prescription: a qualitative study. Biomed Res, 2018; 29(21):3792-6. https://doi.org/10.4066/biomedicalresearch.29-18-1112

Mishra S, Mohanty SK. Out-of-pocket expenditure and distress financing on institutional delivery in India. Int J Equity Health, 2019; 18(1):99. https://doi.org/10.1186/s12939-019-1001-7

Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. Lancet Infect Dis, 2011; 11(9):692-701. https://doi.org/10.1016/S1473-3099(11)70054-8

Nga DT, Chuc NT, Hoa NP, Hoa NQ, Nguyen NT, Loan H, Toan T, Phuc H, Horby P, Yen P, Kinh N, Wertheim H. Antibiotic sales in rural and urban pharmacies in northern Vietnam: an observational study. BMC Pharmacol Toxicol, 2014; 15(1):6. https://doi.org/10.1186/2050-6511-15-6

Roque F, Soares S, Breitenfeld L, López-Durán A, Figueiras A, Herdeiro MT. Attitudes of community pharmacists to antibiotic dispensing and microbial resistance: a qualitative study in Portugal. Int J Clin Pharm, 2013; 35(3):417-24. https://doi.org/10.1007/s11096-013-9753-4

Sabry NA, Farid SF, Dawoud DM. Antibiotic dispensing in Egyptian community pharmacies: an observational study. Res Soc Adm Pharm, 2014; 10(1):168-84; doi: 10.1016/j.sapharm.2013.03.004. https://doi.org/10.1016/j.sapharm.2013.03.004

Saengcharoen W, Chongsuvivatwong V, Lerkiatbundit S, Wongpoowarak P. Factors influencing dispensing of antibiotics for upper respiratory infections among southern Thai community pharmacists. J Clin Pharm Ther, 2008; 33(2):123-9. https://doi.org/10.1111/j.1365-2710.2007.00890.x

Saha S, Hossain MT. Evaluation of medicines dispensing pattern of private pharmacies in Rajshahi, Bangladesh. BMC Health Services Res, 2017; 17(1):136; doi:10.1186/s12913-017-2072-z. https://doi.org/10.1186/s12913-017-2072-z

Saleem Z, Hassali MA, Hashmi FK, Godman B, Saleem F. Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan. Fam Med Community Health, 2019; 7(3):e000138; doi:10.1136/fmch- 2019-000138. https://doi.org/10.1136/fmch-2019-000138

Sarwar MR, Saqib A, Iftikhar S, Sadiq T. Knowledge of community pharmacists about antibiotics, and their perceptions and practices regarding antimicrobial stewardship: a cross-sectional study in Punjab, Pakistan. Infect Drug Resist, 2018; 11:133-45; doi:10.2147/IDR. S148102. https://doi.org/10.2147/IDR

Salim AMA, Elgizoli B. Exploring the reasons why pharmacists dispense antibiotics without prescriptions in Khartoum state, Sudan. Int J Pharm Pract, 2016; 25(1):59-65. https://doi.org/10.1111/ijpp.12317

Servia-Dopazo M, Figueiras A. Determinants of antibiotic dispensing without prescription: a systematic review. J Antimicrob Chemother, 2018; 73(12):3244-53. https://doi.org/10.1093/jac/dky319

Siltrakool B, Berrou I, Griffiths D, Alghamdi S. Antibiotics' use in Thailand: community pharmacists' knowledge, attitudes and practices. Antibiotics, 2021; 10(2):137. https://doi.org/10.3390/antibiotics10020137

Soumya R, Devarashetty V, Jayanthi CR, Sushma M. Drug dispensing practices at pharmacies in Bengaluru: a cross-sectional study. Indian J Pharmacol, 2016; 48(4):360-4; doi:10.4103/0253-7613.186204. https://doi.org/10.4103/0253-7613.186204

Torres NF, Solomon VP, Middleton LE. Identifying the commonly used antibiotics for self-medication in urban Mozambique: a qualitative study. BMJ Open, 2020; 10(12):e041323. https://doi.org/10.1136/bmjopen-2020-041323

World Health Organization. Antibiotic resistance. 2022 Available via https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance (Accessed 21 January 2021)

Yaacoub SG, Lahoud NA, Francis NJ, Rahme DW, Murr TH, Maison PF, Saleh NG. Antibiotic prescribing rate in lebanese community pharmacies: a nationwide patient-simulated study of acute bacterial rhinosinusitis. J Epidemiol Glob Health, 2019; 9(1):44-9; doi:10.2991/ jegh.k.190305.001. https://doi.org/10.2991/jegh.k.190305.001

Zakaa El-Din M, Samy F, Mohamed A, Hamdy F, Yasser S, Ehab M. Egyptian community pharmacists' attitudes and practices towards antibiotic dispensing and antibiotic resistance; a cross-sectional survey in Greater Cairo. Curr Med Res Opin, 2019; 35(6):939- 46; doi:10.1080/03007995.2018.1544119. https://doi.org/10.1080/03007995.2018.1544119

Zawahir S, Lekamwasam S, Aslani P. A cross-sectional national survey of community pharmacy staff: knowledge and antibiotic provision. PLoS One, 2019; 14(4):e0215484. https://doi.org/10.1371/journal.pone.0215484

Article Metrics

1 Absract views 1 PDF Downloads 2 Total views

   Abstract      Pdf Download

Related Search

By author names

Citiaion Alert By Google Scholar

Name Required
Email Required Invalid Email Address

Comment required