Pakistan should immediately curb the sale of non‐prescribed antibiotics from community pharmacies

Aziz, Muhammad Majid; Fang, Yu

doi:10.1002/hpm.2765

Cited by 7 publications

(7 citation statements)

References 6 publications

(7 reference statements)

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“…In this study, we showed that pharmacy retailers had insufficient knowledge about regulations regarding the sale of antibiotics without a prescription. Similar to a study from Saudi Arabia [ 4 ], most participants believed that they were authorized to engage in DoNA, which revealed their lack of awareness of the NDP [ 16 ].…”

Section: Discussionmentioning

confidence: 65%

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Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion

et al. 2021

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Community pharmacies are the main channel of antibiotics distribution. We aimed to analyze the dispensing of non-prescribed antibiotics and knowledge of pharmacy staff. We conducted a cross-sectional study in Punjab, Pakistan between December 2017 and March 2018. A self-administered, structured, pretested, and validated bilingual questionnaire was used, and we used chi-square tests in the statistical analysis. A total of 573 (91.7%) pharmacy retailers responded to the survey; 44.0% were aged 31–40 years and all were men. Approximately 81.5% of participants declared that dispensing non-prescribed antibiotics is a common practice in community pharmacies, and 51.1% considered themselves to be authorized to dispense these drugs; 69.3% believed this a contributing factor to antimicrobial resistance. Most (79.1%) respondents believed that this practice promotes irrational antibiotics use, and half (52.2%) considered antimicrobial resistance to be a public health issue. Only 34.5% of respondents reported recommending that patients consult with a doctor prior to using antibiotics, and 61.8% perceived that their dispensing practices reduce patients’ economic burden. Approximately 44.9% of pharmacy retailers stated that they have proper knowledge about antibiotics use. Nitroimidazole was the main class of antibiotic dispensed without a prescription. Dispensing of injectable and broad-spectrum antibiotics can be potential threat for infection cure. Poor knowledge of staff is associated with dispensing of non-prescribed antibiotics. This inappropriate practice must be addressed immediately.

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Section: Discussionmentioning

confidence: 65%

“…However, the sale of non-prescribed antibiotics is completely prohibited by the national drug policy (NDP) of Pakistan. The NDPemphasizes that all types of antibiotics should sold by pharmacies only with a valid prescription from a registered doctor [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion

et al. 2021

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“…Pakistan is the third-largest consumer of antimicrobials among LMICs, followed by India and China, with a 67% increase in their use from 2000 to 2015, which is similar to other South Asian countries [32,33]. In addition, an appreciable proportion of the global burden of AMR is reported to be from South Asian countries, including Pakistan [34].…”

Section: Introductionmentioning

confidence: 74%

Understanding of Final Year Medical, Pharmacy and Nursing Students in Pakistan towards Antibiotic Use, Antimicrobial Resistance and Stewardship: Findings and Implications

Raees

Atif²,

Aslam

et al. 2023

Antibiotics

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Antimicrobial resistance (AMR) is a leading public health threat, which is exacerbated by the high and inappropriate use of antibiotics. Consequently, there is a need to evaluate knowledge regarding antibiotic use, AMR and the readiness to implement antimicrobial stewardship programs (ASPs) among final year medical, pharmacy and nursing students in Pakistan. This reflects the high and increasing rates of AMR in the country, and students as future healthcare professionals (HCPs). A cross-sectional study was conducted among 1251 final year students from 23 public and private educational institutions in Punjab. The majority of the surveyed participants possessed good knowledge of antibiotic use, AMR and the potential causes of AMR. The most common sources of the information on antibiotics were smartphones (69.9%), peers (35.9%) and medical textbooks (30.6%). However, most surveyed participants were not fully prepared to participate in ASPs. They knew, though, how to reduce AMR by educating HCPs about appropriate prescribing, implementing ASPs and improving laboratory facilities. There was a significant association between antibiotic knowledge and causes of AMR with sex, family income and student type (p < 0.05). Being a student at a public sector university (OR = 4.809; CI = 3.261–7.094; p < 0.001) and age (OR = 0.524, CI = 0.327–0.842; p < 0.008) were among the key factors impacting students’ training on ASPs. Educational curricula must be improved to include more information about appropriate antibiotic use and ASPs, along with sufficient training, workshops and clinical rotations in the final year, to fully equip students by graduation.

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“…However, use of non-prescription antimicrobials is common in most parts of the world [ 6 ]. In fact, in some LMICs, non-prescription antimicrobials are the most commonly sold medicines among prescription-only drugs [ 7 ]. In our study, most (92%) pharmacy employees agreed that patients asking for antimicrobials without medical prescriptions was a common situation, which is comparable to a study from Eastern Nepal where 77% of respondents agreed on this [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal

et al. 2023

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Background Unregulated antimicrobial use is common in both hospital and community settings of low- and middle-income countries (LMICs). However, discrete data regarding the use/misuse of antimicrobials at pharmacies in LMICs are limited. This study was conducted to understand knowledge, attitude, and practice of pharmacy employees on antimicrobial dispensing in Nepal. Methods We conducted a cross-sectional survey using a structured questionnaire on 801 pharmacy employees working in community and hospital pharmacies located in Lalitpur metropolitan city (LMC) of Kathmandu, Nepal between April 2017 and March 2019. Results A majority (92%) of respondents agreed that demand for non-prescription antimicrobials was common. Asking for prescription before dispensing was ranked as the first preference by majority (69%) of participants. Suspected respiratory tract infection was the most common reason demanding for non-prescription antimicrobials with the highest mean rank of 1.5. Azithromycin was the most commonly prescribed and sold antimicrobial, as reported by 46% and 48% of participants respectively. A majority (87%) of respondents agreed on antimicrobial resistance (AMR) to be a global public health threat; and misuse/overuse of antimicrobials was perceived as the most common cause of AMR with a mean rank of 1.93. Conclusion Our study revealed that unfounded dispensing and use of antimicrobials is prevalent among pharmacies in Kathmandu, Nepal. This over reliance on antimicrobials, notably azithromycin, may escalate burden of AMR. We identified several drivers of inappropriate antimicrobial dispensing practice in pharmacies, which will aid public health authorities in addressing these issues. Further studies considering role of other stakeholders, such as doctors, veterinarians, general public, and policy makers are required to obtain a more holistic perspectives on practices of antimicrobial use so to curb the extant AMR crisis.

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Pakistan should immediately curb the sale of non‐prescribed antibiotics from community pharmacies

Cited by 7 publications

References 6 publications

Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion

Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion

Understanding of Final Year Medical, Pharmacy and Nursing Students in Pakistan towards Antibiotic Use, Antimicrobial Resistance and Stewardship: Findings and Implications

Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal

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