Antibiotic Dispensing Practices in Community Pharmacies: A Major Health Concern in the Eastern Democratic Republic of Congo

Abstract

Aims: The practice of antibiotic dispensing in community pharmacies may contribute to irrational use of antibiotics. The aim of this study was to evaluate the antibiotic dispensing patterns in community pharmacies of the Eastern DRCongo.
 Methods: It is a cross-sectional study carried out at Bukavu city. The study included 1504 subjects attending community pharmacies. Thus, a total number of 40 pharmacies were selected. The sociodemographic profiles of patients and dispensers were also recorded. The pharmacological interventions were investigated in terms of antibiotics dispensed according to patient’s complaints, antibiotic dispensing with or without prescription, the substitution of antibiotics in prescriptions.
 Results: Participants attending pharmacies for antibiotic needs were in the mean age of 29.8±13 years. Most of the pharmacy workers consisted of pharmacy technicians (70%) and no trained dispensers (20%). Pharmacists represented only 10% of all dispensers in community pharmacies. We found that 67.8% of subjects purchased antibiotics without prescription. The antibiotics dispensed without prescription were either on patients’ requests (70.1%) or the suggestion of dispensers (29.9%). Only 18.4% of prescriptions were subject to substitution. The conditions for requiring antibiotic dispensing without prescriptions were respectively gastrointestinal (34%), respiratory (27%), genitourinary (25%), skin (11%) and dental (2%) infections. Conditions that were not well defined represented 1%. In cephalosporins, Cefixime was the most important drug dispensed without prescription (72.5%) whereas in penicillins, this was Amoxicillin (55.5%). Doxycycline was more dispensed in the class of cyclines (69.4%). Erythromycin (53.1%) and Azithromycin (29.4%) were more dispensed in the class of macrolides. Ciprofloxacin was the most dispensed drug in the class of quinolones (74.3%) and Metronidazole (86.8%) in the class of imidazoles.
 Conclusion: The Antibiotic dispensing practice is very critical in the community pharmacies of Bukavu city due to the lack of qualified dispensers. This may increase the antibiotic self-medication and contribute to antibiotic resistance.

Animal source food eating habits of outpatients with antimicrobial resistance in Bukavu, D.R. Congo

“…Here, 68% of E. coli isolates were found to be multidrug resistant (to more than 3 antibiotic families). A similar trend was observed in Bukavu City by previous research that associated the observed multidrug resistance of several micro-organisms including E.coli [7,32,40]. They explained it with an irrational prescription and/ or use of antibiotics in the province.…”

“…The study investigated the question, whether antimicrobial resistance currently observed in patients of Bukavu City could be associated to the eating habits of ASFs. Recent studies report high levels of resistance to antimicrobials in patients visiting hospitals in the city [7,17,18,40]. The increasing trend of resistance to antimicrobials in patients could be reasoned by the widely spread selfmedication and the lack of clear governmental regulations for the use of antibiotics [17,18,40].…”

“…Recent studies report high levels of resistance to antimicrobials in patients visiting hospitals in the city [7,17,18,40]. The increasing trend of resistance to antimicrobials in patients could be reasoned by the widely spread selfmedication and the lack of clear governmental regulations for the use of antibiotics [17,18,40]. Additionally, there is growing concern about the contribution of food from animal origin on the observed resistances to antibiotics in humans.…”

Prevalence and Predictors of Antibiotic Prescriptions at Primary Healthcare Facilities in the Dodoma Region, Central Tanzania: A Retrospective, Cross-Sectional Study

“…The use of antibiotics in clinical practice is mainly manifested by both the transactions of these agents in community drug shops and the antibiotic prescribing practices by healthcare workers across the entire healthcare spectrum [ 2 , 7 , 8 ]. In Tanzania, the health system follows a referral hierarchy where dispensaries and health centres form the primary healthcare block serving a population of 5000 and 50,000 at the village and ward levels, respectively [ 9 ].…”

The Extent of Antibiotic Dispensing in Self-Medication Encounters in Sudan: A Simulated Patient Study Focusing on Cefixime Sale

“… 12 Cefixime is one of the antibiotics that has been noticed to be dispensed without prescriptions. 13 …”