Prescribing and sale of ophthalmic chloramphenicol following reclassification to over-the-counter availability

Abstract

Following the reclassification of chloramphenicol there have been significant increases in the supply of the ophthalmic antibacterials in both England and Wales.

An investigation of prescription and over-the-counter supply of ophthalmic chloramphenicol in Wales in the 5 years following reclassification

“…An important difference between the pharmacy sales data utilised in the present study is that whereas data from Company A represented transactions between pharmacy and customers, IMS Health data reported supplies from wholesalers to pharmacies. As with previous studies that have employed IMS Health sales data, the latter was identified to be a good proxy for pharmacy‐to‐customer sales. This relationship is likely to hold for chloramphenicol eye drops as they need to be stored in a fridge, where space is usually at a premium, and bulk advance purchases are unlikely.…”

“…The pharmacy sales data presented in this study are the first and the most comprehensive dataset studied to date and include data from all NHS‐contracted community pharmacies in Wales. The results demonstrate that the availability of ophthalmic chloramphenicol OTC has contributed to a greater increase in the supply of chloramphenicol than previously identified . Supplies of OTC chloramphenicol eye drops increased from 2005 to 2007 but have subsequently remained stable.…”

“…Since the launch of OTC ophthalmic chloramphenicol two main issues have come to light. First, pharmacy availability of ophthalmic chloramphenicol has been shown to have no impact on prescription supply for the same drug, and overall there was a substantial increase in the supply of chloramphenicol in primary care in the first 3 years following reclassification . Whether this situation remained the same beyond 3 years is unknown.…”

An evaluation of the reclassification of ophthalmic chloramphenicol for the management of acute bacterial conjunctivitis in community pharmacies in Western Australia

“…Although patients could obtain the same treatment from a pharmacist as that medically prescribed, the results have shown that a majority of respondents reported no change in the number of prescriptions received for ophthalmic chloramphenicol. In contrast, researchers in the UK found that since the downscheduling in the UK, the number of GP prescriptions for chloramphenicol fell from 2.3 million in 2004 to 1.94 million in 2007, while OTC provision by pharmacists increased [20,21]. This led to an overall increase of 47.8% in total ophthalmic chloramphenicol use at the same time as a decreased GP workload [20,21]…”

The urgent need to develop emergency EYE care in the UK: the way forward?

“…To give some sense of the scale of the potential attendees that could migrate towards emergency secondary care; ->430 million Pharmacists attendances in England annually for health related reasons 4 ->1 million bottles of over-the-counter chloramphenicol are dispensed annually. 5 -16 million optician sight tests / eye examinations performed annually in the UK 6 -340 million GP consultations of which 1.5 -2% are eye related 4 -24 million calls made to NHS urgent telephone services 4 If even small percentages divert to Hospital Eye Service (HES), continuation of the growth experienced in the past decade is possible.…”