Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review

Implications of non-prescription antibiotic sales in China

“…Concerns are exacerbated by often shorter courses and inappropriate antibiotics being dispensed (3). Overall, rates of non-prescription sales of antibiotics in LMICs are up to 93% of dispensed antibiotics, with up to 100% of pharmacists dispensing antibiotics without a prescription in some LMICs despite legislation against such practises (1,4,5,8,9). Ours and others' experience is that non-prescription antibiotic sales is driven by multiple reasons including pressure from patients and financial reasons, i.e.…”

“…As a result of the findings of Chang et al and our experience, we believe several strategies can be implemented to reduce non-prescription antibiotic sales. These include improving pharmacists' knowledge and practice of AMS starting in pharmacy school coupled with the use of the Internet and educational workshops post qualification (1), making pharmacists more aware of the WHO AWaRe antibiotic list especially which antibiotics not to dispense, as well as developing and implementing national guidelines for pharmacists (1,4,13). Other activities including reinforcing legislation where pertinent, instigating IT surveillance systems to track antibiotics through the supply chain, monitoring pharmacy activities using mobile technologies and increased patient education on the dangers of selfmedication with antibiotics.…”

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

“…Sub-optimal management of URTIs in LMICs including the overuse of antibiotics is promoted by misconceptions, social-cultural issues, diagnostic uncertainty, and clinical competency as well as commercial, patient and time pressures 21,29,50,52,57,92,[96][97][98][99][100][101][102][103][104][105][106][107][108][109] . Inappropriate management is also a concern in countries with high rates of infectious diseases such as HIV, malaria and tuberculosis (TB), which is the case in sub-Saharan Africa, as this may complicate treatment [110][111][112] .…”

The challenges of investigating antimicrobial resistance in Vietnam - what benefits does a One Health approach offer the animal and human health sectors?

“…In comparison to many high-income countries (HIC), access to antibiotics is highly unregulated in LMIC, were consumers can purchase antibiotic treatment from authorised and unauthorised pharmacies without a prescription [7,43]. Evidence has shown that the use and misuse of antibiotics may be associated with broader sociocultural [44] and sociodemographic factors [45]. In the Philippines, a study by Barber et al, found accessing unprescribed antibiotics from the local sari sari (small retail business) stand and antibiotic sharing amongst family and friends was a common practice [46].…”