Dispensing of antibiotics in community pharmacy: an analytical study
Fatima E. Alhaddad, Khaleel M. Abuleid, Laylay A. Aljleedi
Abstract
Worldwide, the threat created by antibiotic resistance to public health calls for immediate action. Antibiotic resistance is one of the main causes of the emergence and spread of dispensing antibiotics without a prescription. This study aims to investigate the dispensing of antibiotics without a prescription and the reason behind that in the community pharmacy in Libya. The study was randomized analytical conducted between March and April 2023 among pharmacists and assistant pharmacists employed by community pharmacies in various Libyan areas Tripoli, Zawia, and Sabratha. The data were analyzed by Fisher's exact and Chi-square tests to predict the determinations of dispensing antibiotics without prescriptions. In this study, a total of 293 participants were included, 63 had been excluded because they did not meet the study's inclusion. The remaining 230 were enrolled for final analysis, most female subjects (70.7%). Findings showed that 78.7% of the participants consulted with patients about the reason for requesting a specific type of antibiotic, while 68.7% dispensed antibiotics with probiotics. Study participants with 2-4 years' work experience were 76.6% higher toward dispensing antibiotics without a prescription (P=0.683). The major reason for dispensing antibiotics without prescriptions was pharmacists knowledgeable enough to give a patient antibiotics without a prescription (68.3%). In Libya, misuse of antibiotics by the public is widespread. People can purchase antibiotics without a prescription. Thus, dispensing of antibiotics without a prescription in community pharmacies is an alarming issue in Libya which can increase antibiotic resistance. Pharmacists' knowledge is high in dispensing patients' antibiotics without a prescription, but patient pressure and financial issues are the major reasons behind dispensing antibiotics without a prescription. It can be recommended that the importance of antimicrobial stewardship and the need for ongoing education support for community pharmacy professionals is of importance.
Keywords
References
- Klein EY, Van Boeckel TP, Martinez EM, Pant S, Gandra S, Levin SA, Goossens H, Laxminarayan R (2018) Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proceedings of the National Academy of Sciences of the United State of America. 115 (15): E3463-E3470. doi: 10.1073/pnas. 1717295115
- Ndaki P, Mushi M, Mwanga J, Konje E, Ntinginya N, Mmbaga B, Keenan K, Sabiiti W, Kesby M, Benitez-Paez F, Sandeman A, Holden M, Mshana S (2021) Dispensing antibiotics without prescription at community pharmacies and accredited drug dispensing outlets in Tanzania: A cross-sectional study. Antibiotics. 10 (8): 1025. doi: 10.3390/antibiotics10081025
- Tanveer A, Kenchey A, Mohammed Z, Lakshmi PK (2022) Assessment of community pharmacists’ knowledge, attitude and practice on antibiotics and antibiotic resistance. Saudi Journal of Medical and Pharmaceutical Sciences. 8 (2): 92-98. doi: 10.36348/sjmps.2022.v08i02.009
- Elkbuli GL, Draidi RA (2021) Prevalence of self-medication phenomenon with antibiotics among university pharmacy students. Mediterranean Journal of Pharmacy and Pharmaceutical Sciences. 1 (4): 44-49. doi: 10.5281/zenodo.5805961
- Elfowiris AO, Majed NSS (2022) Antibiotic prescribing in pediatric health care services. Mediterranean Journal of Pharmacy and Pharmaceutical Sciences. 2 (3): 12-16. doi: 10.5281/zenodo.7115130
- Meerah WAA (2023) Evaluation of self-medication with antibiotics in Libyan community. Mediterranean Journal of Pharmacy and Pharmaceutical Sciences. 3 (1): 77-81, 2023 doi.org/10.5281/zenodo.7771724
- Smeda H, Murghem A, Khapoli A, Gaunos S, Alahrish R, Sherif FM, Alsharif SM (2020) Knowledge, attitude and pattern of antibiotic utilization among Libyan University students in Zawia. Iberoamerican Journal of Medicine. 161-166. doi: 10.5281/zenodo.3746060
- Sherif FM (2008) An evaluation of the prescribing patterns of drugs in Libya. Jamahiriya Medical Journal. 8: 203-206. doi: Nil.
- Mbwasi R, Mapunjo S, Wittenauer R, Valimba R, Msovela K, Werth BJ, Khea A M, Nkiligi EA, Lusaya E, Stergachis A, Konduri N (2020) National consumption of antimicrobials in Tanzania: 2017-2019. Frontiers in Pharmacology. 11. doi: 10.3389/fphar.2020.585553
- Kalungia AC, Burger J, Godman, B, Costa JDO, Simuwelu C (2016) Non-prescription sale and dispensing of antibiotics in community pharmacies in Zambia. Expert Review of Anti-infective Therapy. 14 (12): 1215-1223. doi: Nil.
- Llor C, Cots JM (2009) The sale of antibiotics without prescription in pharmacies in Catalonia, Spain. Clinical Infectious Diseases. 48 (10): 1345-1349. doi: 10.1086/598183
- World Health Organization (1970) The role of pharmacist in encouraging prudent use of antibiotics and averting antimicrobial resistance: A review of policy and experience. World Health Organization. Retrieved April 15, 2023, from https://apps.who.int/iris/handle/10665/139702
- Chandran DS, Manickavasagam PP (2022) Sale of antibiotics without prescription in stand-alone pharmacies in Tamil Nadu. Journal of Family Medicine and Primary Care. 11 (9): 5516-5520. doi: 10.4103/jfmpc. jfmpc_2157_21
- Shi L, Chang J, Liu X, Zhai P, Hu S, Li P, Hayat K, Kabba JA, Feng Z, Yang C, Jiang M, Zhao M, Hu H, Fang Y (2020) Dispensing antibiotics without a prescription for acute cough associated with common cold at community pharmacies in Shenyang, northeastern China: A cross-sectional study. Antibiotics. 9 (4): 163. doi: 10.3390/antibiotics9040163
- Haile KT, Yabeyu AB (2022) Knowledge, attitude and practice of pharmacy professionals against dispensing antibiotics without prescription in Ethiopia. Integrated Pharmacy Research and Practice. 11: 167-176. doi: 10.2147/iprp.s383709
- Bahta M, Tesfamariam S, Weldemariam DG, Yemane H, Tesfamariam EH, Alem T, Russom M (2020) Dispensing of antibiotics without prescription and associated factors in drug retail outlets of Eritrea: A simulated client method. PLoS ONE. 15 (1). doi: 10.1371/journal.pone.0228013
- Ahmad T, Khan FU, Ali S, Rahman AU, Ali Khan S (2022) Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client’s study. PLoS ONE. 17 (2). doi: 10.1371/journal.pone.0263756
- Hadi MA, Karami NA, Al-Muwalid, AS, Al-Otabi A, Al-Subahi E, Bamomen A, Mohamed MMA, Elrggal ME (2016) Community pharmacists’ knowledge, attitude, and practices towards dispensing antibiotics without prescription (DAwP): A cross-sectional survey in Makkah Province, Saudi Arabia. International Journal of Infectious Diseases. 47: 95-100. doi: 10.1016/j.ijid.2016.06.003
Submitted date:
10/06/2023
Reviewed date:
10/28/2023
Accepted date:
11/05/2023
Publication date:
11/16/2023