A National Survey of Dispensing Practice and Customer Knowledge on Antibiotic Use in Vietnam and the Implications

Abstract

Misconceptions and pressures have increased the sales of antibiotics without a prescription across countries. There are concerns with such practices in Vietnam given rising antimicrobial resistance rates. A national survey was conducted among 360 private drugstores located in nine provinces in Vietnam. Anonymous interviews were conducted with participants selected by convenience sampling. Subsequently, multivariable logistic regression analyses were undertaken evaluating the relationship between customer characteristics and antibiotic purchases. A total of 480 out of 1626 surveyed participants purchased antibiotics, 81.7% of which did not have a prescription, involving 29 different antibiotics. In 86.4% of these, participants were prescribed antibiotics by drug sellers. Most antibiotics were sold to treat respiratory tract infections (61.4%), with the ‘Access’ antibiotics (amoxicillin and cephalexin) being the most frequently sold. Only one-fifth of participants understood that they were breaking the law by purchasing antibiotics without a prescription. Participants purchasing antibiotics without a prescription had lower awareness concerning antibiotic laws and treatment duration (p < 0.05). Under 50% agreed to having a doctors’ prescription in the future when purchasing antibiotics. Freelancer occupation (OR = 0.52, 95% CI = 0.83–0.96) and a lower educational level (OR = 0.49, 95% CI = 0.25–0.96) were factors related to purchasing antibiotics without a prescription. Overall, we recommend increasing fines and monitoring of drugs stores, greater promotion of the family doctor system as well as increasing media and educational campaigns to limit self-purchasing of antibiotics in Vietnam and reduce resistance.

Determinants of the Empiric Use of Antibiotics by General Practitioners in South Africa: Observational, Analytic, Cross-Sectional Study

“…These were firstly surveillance of antimicrobial resistance data and antibiotic use; secondly infection prevention control and lastly antimicrobial stewardship [ 30 ]. However, there is currently limited data nationally regarding antimicrobial use in ambulatory care among LMICs, which is exacerbated by the considerable purchasing of antibiotics without a prescription that still takes place in a number of these countries [ 10 , 31 , 32 , 33 ].…”

Life-course inequalities in intrinsic capacity and healthy ageing, China

“…For example, in Saudi Arabia, sales of antibiotics without a prescription decreased after fines were increased and regulations were enforced; 44 however, in Viet Nam, increased fines did not significantly affect such sales. 45 A system of standardized prescriptions could be developed with traceable authentication, for example, a quick response (QR) code. New technology such as tracking and tracing systems could also be applied.…”

Developing a Tool for Auditing the Quality of Antibiotic Dispensing in Community Pharmacies: A Pilot Study

“…As dispensing practice should differ for different drug classes, specified documentation methods are needed for specific drug classes to ensure obtaining detailed information, which can be used for specific improvements in practice. Studies that focus on antibiotic dispensing have been performed around the globe [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], but mainly aim to identify patterns in dispensing practices, e.g., regarding the type of antibiotic dispensed or over-the-counter dispensing of antibiotics. Such studies seem very relevant to picture general antibiotic use; nonetheless, they might not be as useful in providing specific improvements for community pharmacy practice.…”