Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client's study

PLoS One. 2022 Feb 17;17(2):e0263756. doi: 10.1371/journal.pone.0263756. eCollection 2022.

Abstract

Antibiotics dispensing without a prescription is an irrational practice and can increase the risk of antibiotic resistance, which is a significant public health concern around the globe. This study was aimed to determine the extent to which antibiotics are supplied without prescription in the community pharmacies (CPs) at Hazara Division from November 2020 to February 2021. The simulated client method (SCM) was used, and the data were gathered, recorded, and analyzed through different statistical methods with descriptive and inferential techniques. The antibiotic dispensing was observed in CPs (90.5%), the most dispensed antibiotics were azithromycin (29.4%) and ciprofloxacin (46.5%) respectively. Furthermore, visited medical stores/ drug outlets, 9.5% of the visited stores denied dispensing of antibiotics because they preferred a referral to visit physicians (23. 9%) and (12.8%) did not had the antibiotics at the time of visits. Antibiotics were more obtainable in retail medical stores (AOR = 8.6, 95 percent Cl: 3.0-24.7; p = 0.001) than in pharmacies. In rural areas antibiotics dispensing was more (p = 0.004) as compared to urban areas. Staff members also had asked about patient's (17.7%) symptoms and drug allergies (12.3% and 3.9%), and (1.5%) they consoled them about their medications. The findings of this study indicate that nonprescription antibiotic sales are very common, despite national rules prohibiting this activity. When the simulated Client requested for any medication to relieve his or her discomfort, many antibiotics were given out without a prescription. Pharmacies/medical stores in Hazara Division selling antibiotics without a prescription are worrying and need immediate action by regulators.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Commerce / statistics & numerical data*
  • Community Pharmacy Services / statistics & numerical data*
  • Computer Simulation*
  • Cross-Sectional Studies
  • Humans
  • Male
  • Nonprescription Drugs / supply & distribution*
  • Pakistan
  • Self Medication / statistics & numerical data*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Nonprescription Drugs

Grants and funding

No fund was obtained.