Assessment of Prescribing Practices and Factors Related to Antibiotic Prescribing in Community Pharmacies

Abstract

Background and Objectives: Overprescribing of antibiotics is one of the important contributors of antimicrobial resistance globally. A high proportion of antibiotics prescribed in community settings are unnecessary or inappropriate. This study assesses the prescribing practices and factors related to antibiotic prescribing in community pharmacies in United Arab Emirates (UAE). Materials and Methods: A cross-sectional study utilizing a quantitative approach was carried out in the community pharmacies of Ras Al Khaimah (RAK), UAE. Six hundred and thirty prescription encounters from 21 randomly selected community pharmacies were investigated using World Health Organization (WHO) core prescribing indicators. Factors related to antibiotic prescribing were identified using logistic regression analyses. Results: In 630 prescription encounters, a total of 1814 drugs were prescribed. Out of these, the most commonly prescribed drug class was antibiotics (43.8% prescriptions) and the antibiotic was amoxicillin/clavulanic-acid (22.4%). The average number of drugs per prescription was 2.88, which was higher than the WHO recommended value of 1.6–1.8. In addition, more than half of the prescriptions (58.6%) had drugs by generic names and the majority of the drugs prescribed (83.8%) were from the essential drug list, which were lower than the optimal values of 100%. The majority of the antibiotics prescribed in the study were from the WHO’s Access group antibiotics. Multivariable logistic regression analysis identified patient age (children—OR: 7.40, 95% CI: 2.32–23.62, p = 0.001 and adolescent—OR: 5.86, 95% CI: 1.57–21.86, p = 0.008), prescriber qualification as general practitioner (OR: 1.84, 95% CI:1.30–2.60, p = 0.001), and number of drugs per prescription (OR: 3.51, 95% CI: 1.98–6.21, p < 0.001) as independent factors associated with antibiotic prescribing. Conclusions: This study reveals considerable variations from the WHO recommendations for the different prescribing indicators in the community pharmacies of RAK, UAE. In addition, the study reports overprescribing of antibiotics in the community setting, indicating the need for interventions to promote rational use of antibiotics in a community setting.

Evaluating drug use patterns among paediatric outpatients in Burundi

“…Even though the percentage of drugs prescribed from EMLs were lower compared to WHO optimal value for the current study, the results were higher than more other findings revealed from studies conducted in India (37.37%; 58.3%), Nepal (65.8%; 80.9%), UAE(47.7%; 83.8%), Sri Lanka (68.8%), and Sudan (81.19%) (Abu Farha et al, 2022 ; Aryal et al, 2020 ; Atal et al, 2021 ; Galappatthy et al, 2021b ; Mandal et al, 2022 ; Rabbani et al, 2023 ; Shrestha et al, 2021 ; Yousif & Supakankunti, 2016 ).…”

“…These findings were higher than the WHO optimal value (100%). Comparing these results to others from previous similar studies, lower results were found in India (15.96%), Nepal (57.7%), United Arab Emirates (UAE) (58.6%), Pakistan (56.6%), Sri Lanka (35.5%), Kenya (27.7%), Ghana (76%), Sudan (49.8%), and African region systematic review (68%) (Abdin & Mohammed, 2021 ; Amponsah et al, 2022 ; Atal et al, 2021 ; Atif et al, 2016b ; Galappatthy et al, 2021b ; Nyabuti et al, 2020 ; Ofori-Asenso et al, 2016 ; Rabbani et al, 2023 ; Shrestha et al, 2021 ). These lower results could be attributed to the non-establishment or non-enforcement of the regulatory policies.…”

“…The percentage of encounters in which a patient was prescribed at least one injection in the present study was 9.9%, which is closer the value found in 2014 Burundi outpatient encounter study all ages considered (Holloway & Henry, 2014 ), was lower than the value recommended by WHO (13.4–24.1). Results were similar to those from studies conducted in India (1.98%; 0.64%), Northwest Ethiopia (9.5%), Nepal (0.6%, 4.2%), UAE (9.5%; 0.5%), Pakistan (0%), Sri Lanka (1.2%), Ghana (7%), and in Rwanda (1.2%) (Abu Farha et al, 2022 ; Amponsah et al, 2022 ; Aryal et al, 2020 ; Atal et al, 2021 ; Atif et al, 2016b ; Galappatthy et al, 2021b ; Habimana et al, 2020 ; Mandal et al, 2022 ; Rabbani et al, 2023 ; Sema et al, 2021 ; Shrestha et al, 2021 ). In contrast, the results that exceeded the WHO optimal values were revealed from Iran (24.4%), the 1995–2015 African region systematic review (25%), and Kenya (24.9%) (Ahmadi & Zarei, 2017 ; Nyabuti et al, 2020 ; Ofori-Asenso et al, 2016 ).…”

Antibiotic prescribing practice using WHO Access, Watch and Reserve classification and its determinants among outpatient prescriptions dispensed to elderly population in six community chain pharmacies in Asmara, Eritrea: a cross-sectional study

“…25 30 However, it is lower than studies conducted in Ethiopia (58.1%), 30 Italy (39.1%), 14 Nepal (48.46%), 15 Sierra Leone (94.9%) 31 and United Arab Emirates (43.8%). 32 The variation in results could be due to differences in study design, study setting and study population. Caution should be exercised when comparing results between the current study and studies conducted in Bangladesh, Ethiopia, Sierra Leone and the United Arab Emirates due to differences in the study population.…”