Exploration of over the counter sales of antibiotics in community pharmacies of Addis Ababa, Ethiopia: pharmacy professionals’ perspective

Abstract

BackgroundOver the counter sale of antibiotics is a global problem and it is increasingly recognized as a source of antibiotic misuse and is believed to increase treatment costs, adverse effects of treatment and emergence of resistance. The increasing trend of over the counter sale of antibiotics in Ethiopia calls for exploration of why such dispensing is practiced. This study aims to explore reasons for over the counter sale of antibiotics in the community pharmacies of Addis Ababa, Ethiopia.MethodsA phenomenological qualitative study was conducted in five randomly selected community pharmacies of Addis Ababa. One pharmacy professional from each pharmacy were interviewed at the spot using semi-structured, open-ended interview checklist. Besides, observation of professionals’ dispensing practice was made for at least one hour in the same community pharmacies using an observation checklist. Findings were categorized into specific themes that were developed following the objectives. This was facilitated by use of OpenCode 3.6 software.ResultsAll participants pointed out that antibiotics were frequently dispensed without prescription and contend that the trend of such dispensing has been increasing. The findings indicated that the nonprescription sales of antibiotics were common for Amoxicillin, Ciprofloxacin and Cotrimoxazole. The poor, less educated and younger groups of the population were reported to frequently request antibiotics without prescription. The main reasons for nonprescription sale of antibiotics by pharmacy professionals were found to be related to pharmacy owner’s influence to maximize revenue, customer’s pressure, weak regulatory mechanism and professional conflicts of interest.ConclusionThe study shows that nonprescription sale of antibiotics was common practice at least in Addis Ababa. The main reasons for this malpractice were the need to maximize revenue and weak regulatory mechanism. Hence, strong regulatory enforcement and community awareness campaign is called for to limit nonprescription sale of antibiotics.

Determinants of Inappropriate Antibiotics Use in Rural Central Ghana Using a Mixed Methods Approach

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Effectiveness of an educational intervention to improve antibiotic dispensing practices for acute respiratory illness among drug sellers in pharmacies, a pilot study in Bangladesh

“…Community pharmacies are also the preferred point of care for acute respiratory illness (ARI) [7–10]. Although most ARIs are self-limited and caused by respiratory viruses [11], drug sellers often recommend and dispense antibiotics without prescription [12–18]. Even though the Bangladesh’s 2005 National Drug Policy prohibits drug sellers from dispensing antibiotics without a physician’s prescription, this law is not enforced [19].…”

Customers’ perceptions of and satisfaction with medicine retail outlet services in Addis Ababa, Ethiopia: a cross-sectional study

“…In contrast, some evidence, especially from developing countries, shows that there are gaps in community pharmacy practices. For instance, selling antibiotics without prescription is illegal in Ethiopia but there are reports which show these practices are occurring …”

“…For instance, selling antibiotics without prescription is illegal [21] in Ethiopia but there are reports which show these practices are occurring. [22] The code of ethics and standards of practice for pharmacists practicing in Ethiopia demands pharmacists to give ample verbal and written information to patients and to counsel their patients in a conducive environment. [23] In India, practicing community pharmacists agree that patient counselling is their professional obligation but not all of them counsel their consumers.…”