Antimicrobial Dispensing Practice in Community Pharmacies in Russia during the COVID-19 Pandemic

Abstract

COVID-19 has had a significant impact on health care systems, including drug use. The present study aimed to evaluate the patterns of community supply of antimicrobials from community pharmacies during the COVID-19 pandemic in five cities of Russia. In a cross-sectional study, a random sample of pharmacies reported all episodes of antimicrobials supply during a one-week period. Patterns of supply (age and gender of customer, drug name and formulation, prescription availability, indication, etc.) were analyzed. Altogether, 71 pharmacies took part in the study and 5270 encounters were recorded. In total, 4.2% of visits resulted in supply of more than one antimicrobial agent and 5.2% were for parenteral formulations. The rate of prescription-based purchase in participated cities varied from 40.5 to 99.1%. Systemic antibiotics and antivirals accounted for the majority of supplies (60.5 and 26.3%, respectively). Upper respiratory tract infections were reported as the indication for antimicrobials usage in 36.9% of cases, followed by skin and soft tissue infections (12.1%) and urinary tract infections (8.7%); COVID-19 accounted for 8.4% of all supplies. Amoxicillin with clavulanic acid, azithromycin and amoxicillin were indicated as the top three antimicrobials purchased for upper respiratory tract infections, and azithromycin, umifenovir and levofloxacin were the top three for COVID-19. In general, a high rate of drugs dispensing without prescription was revealed. Antibiotics for systemic use remained the most common antimicrobials, whereas presumably viral upper respiratory tract infections were the main reason for their purchase. COVID-19 infection itself was responsible for a small proportion of the supply of antimicrobial agents, but systemic antibiotics accounted for more than a half of supplies.

Antibiotic prescribing practices in community and clinical settings during the COVID-19 pandemic in Nairobi, Kenya

“…This high rate of antibiotic use is unsurprising given the inappropriate and empiric prescribing of antibiotics without proper diagnosis or prescription, which is prevalent in both community and hospital settings in Kenya even outside of the pandemic period [ 17 , 21 ]. This finding is consistent with previous studies describing high rates of inappropriate antibiotic prescription in community pharmacies in Indonesia [ 22 ], Tanzania and Uganda [ 23 ], Saudi Arabia [ 24 ] and Russia [ 25 ], as well as among the general public to prevent or manage COVID-19 [ 14 , 26 , 27 ]. A recent metanalysis of global studies reported a pooled prevalence of 74.6% antibiotic usage amongst hospitalised COVID-19 patients [ 28 ].…”

Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan

“…Others common indications were the prevention and treatment of COVID-19, where again antibiotics may not be necessary, with, as mentioned, little evidence of bacterial infections in these patients [ 14 , 22 , 23 ]. This is similar to a study from Russia where the majority of the antibiotics dispensed in ambulatory care were for respiratory and skin and soft-tissue infections [ 68 ].…”

Genetic Determinants of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium and Their Prevalence in Moscow, Russia

“…A study devoted to the screening of M. genitalium resistance in four cities of the Russian Federation identified seven cases with combined resistance out of 659 cases in total (1.1%); however, more recent results reported in 2021 indicate that the prevalence of such isolates has increased up to 6.3% (17/268 cases) [ 36 , 37 ]. One of the plausible causes for the increase in the number of samples with such a genotype is selective pressure from macrolide and fluoroquinolone therapy due to the extensive use of these agents in both in-patient facilities and ambulatory treatment in recent years, especially in conjunction with anti-COVID-19 therapy [ 38 ]. The empirical prescription of these agents without an opportunity for timely STD diagnosis and a lack of therapy efficacy checks via confirmatory tests at the same time could promote the clonal expansion of such strains.…”