Dispensing Antibiotics without a Prescription for Acute Cough Associated with Common Cold at Community Pharmacies in Shenyang, Northeastern China: A Cross-Sectional Study

Shi, Li; Chang, Jie; Liu, Xiaoxi; Zhai, Panpan; Hu, Shuchen; Li, Pengchao; Hayat, Khezar; Kabba, John Alimamy; Feng, Zhanbin; Yang, Caijun; Jiang, Minghuan; Zhao, Mingyue; Hu, Hao; Fang, Yu

doi:10.3390/antibiotics9040163

Cited by 24 publications

(35 citation statements)

References 28 publications

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“…A recent study found that the attitude of pharmacists regarding antimicrobial stewardship programs (ASPs) was positive. However, certain gaps in knowledge about some aspects of antimicrobials and participation in ASPs were highlighted coupled with a poor quality of pharmacy services [17,21,22]. No study has been undertaken to investigate the view of pharmacy staff toward ASPs.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitude, and practices of community pharmacy staff toward antimicrobial stewardship programs: a cross-sectional study from Northeastern China

Feng

Hayat

Zhe

et al. 2020

Expert Review of Anti-infective Therapy

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Background: Antimicrobial resistance is one of the most significant challenges of the twenty-first century, and the illegal sale of antimicrobial drugs at community pharmacies is a driver of antimicrobial resistance. This study explores the knowledge, attitudes, and practices (KAP) of pharmacy staff toward antimicrobial stewardship programs (ASPs). Methods: We conducted a descriptive cross-sectional study among community pharmacy staff in Northeastern China, from April 1 to 31 May 2019, using a self-administered KAP questionnaire comprising 20 items. The data analysis was carried out by employing Mann-Whitney and Kruskal-Wallis tests. Results: A response rate of 98.5% (394/400) was obtained. The majority of participants (94.9%) demonstrated a good understanding of antimicrobial use, but they lacked an adequate understanding of ASPs. Nearly half of the participants (40.6%) reported that they sold antimicrobials to patients without a prescription. Education level, age, occupation, and experience were all significantly associated (P < 0.05) with participants' median ASPs scores. Besides, the presence of a licensed pharmacist (OR 46.327, 95% CI 2.443-878.451, P = 0.011) was the main factor associated with the pharmacy staff's understanding of antimicrobial use policies. Conclusions: The participants' knowledge of antimicrobials was good, and their attitudes regarding ASPs were positive, but their practices regarding ASPs were poor.

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Section: Introductionmentioning

confidence: 99%

Knowledge, attitude, and practices of community pharmacy staff toward antimicrobial stewardship programs: a cross-sectional study from Northeastern China

Feng

Hayat

Zhe

et al. 2020

Expert Review of Anti-infective Therapy

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“…The inappropriate use of antimicrobial drugs has become one of the main causes of increased AMDR worldwide [2]. Therefore, current strategies to combat AMDR are primarily focused on antimicrobial stewardship [3][4][5]. Moreover, according to the One Health perspective, AMDR can occur for different reasons, including human, animal or environmental factors [6,7].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

et al. 2020

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Antimicrobial resistance is a growing global health problem. Patients living in care homes are a vulnerable high-risk population colonized by multidrug-resistant organisms (MDRO). We identified a case series of 116 residents of care homes from a cohort of 540 consecutive patients admitted to the internal medicine service of our hospital. We performed early diagnostic tests of MDRO through anal exudates in our sample. The prevalence of MDRO colonization was 34.5% of residents and 70% of them had not been previously identified in the clinical records. Previous hospitalizations and in-hospital antibiotic administration were significantly associated with the presence of MDRO. Our results emphasize the need to consider care homes in the planning of regional and national infection control measures and for implementing surveillance systems that monitor the spread of antimicrobial resistance in Spain. Systematic early testing upon admission to hospital services with a high prevalence of patients with MDRO colonization (e.g., internal medicine) could contribute to the adoption of adequate prevention measures. Specific educational programs for care home staff should also be implemented to address this increasing problem.

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“…In some studies, antibiotics were dispensed at the recommendation of the drugstore staff [11], [40], [43]. Conversely, in many simulated studies, antibiotics were mostly sold or dispensed by customer demand rather on the advice and recommendation of the attending staff [9], [44], [45]. Prescriptions were requested from the SCs in only 16.8% cases which indicates that strict implementation of the drug rules is required at the drugstores.…”

Section: Discussionmentioning

confidence: 99%

A simulated client exploration of nonprescription availability of antibiotics at drugstores for childhood acute diarrhea and upper respiratory infection in Lahore, Pakistan

Rasheed¹,

Chang²,

Hashmi³

et al. 2020

Preprint

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Background The excessive consumption of antibiotics is a major contributor to antimicrobial resistance, especially in children. Children are often being advised antibiotics for viral infections. In developing countries, the drugstores are a prime source of easy access to nonprescription antibiotics. Also, in Pakistan, their irrational use is an “everyday routine”. The study, therefore, aimed to evaluate the dispensing of nonprescription antibiotics for children at drugstores of Lahore, Pakistan.Methods Using the pediatric acute diarrhea and acute upper respiratory infection as disease scenarios, a simulated client, cross-sectional study was conducted in Lahore, Pakistan to explore the antibiotics’ ease of availability at both categories of drugstores (pharmacies and medical stores) from November 1st, 2019 to January 31st, 2020. Chi-square (x2) test was used to compare the differences in practices of different categorical variables. Multivariable logistic regression was applied to analyze the association of various factors with antibiotics dispensing.Results Antibiotics were dispensed without prescription in 456 (59%) of 773 simulated visits out of which 425 (93.2%) were dispensed on the advice of the drugstore staff. The qualified pharmacist was available in only 164 (21.2%) cases. Of 386 visits for acute diarrhea and 387 for acute upper respiratory infection, nonprescription antibiotic dispensing occurred in 259 (67.1%) and 197 (50.9%) visits respectively. The considerable differences (p-value < 0.05) were observed between the practices of the towns, disease scenario presented, categories of drugstores, and pharmacist-supervised drugstores. Conclusions The inappropriate dispensing practices were prevalent to a large extent at the drugstores and antibiotics were effortlessly obtainable without prescriptions. The quality of the services provided, especially by the non-pharmacist staff, was also not satisfactory. Therefore, the Drug Regulating Authority of Pakistan must enforce strict implementation of drug laws at the drugstores without delays especially in major cities to help curb the felonious use of antibiotics.

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Dispensing Antibiotics without a Prescription for Acute Cough Associated with Common Cold at Community Pharmacies in Shenyang, Northeastern China: A Cross-Sectional Study

Cited by 24 publications

References 28 publications

Knowledge, attitude, and practices of community pharmacy staff toward antimicrobial stewardship programs: a cross-sectional study from Northeastern China

Knowledge, attitude, and practices of community pharmacy staff toward antimicrobial stewardship programs: a cross-sectional study from Northeastern China

Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

A simulated client exploration of nonprescription availability of antibiotics at drugstores for childhood acute diarrhea and upper respiratory infection in Lahore, Pakistan

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