Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan
Antibiotics are one of the most frequently dispensed classes of medicines. However, excessive misuse and abuse enhances antimicrobial resistance (AMR). Previous studies in Pakistan have documented extensive dispensing of ‘Watch’ and ‘Reserve’ antibiotics, which is a concern. In view of this, there i...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-06-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/12/6/1018 |
| _version_ | 1797596380464676864 |
|---|---|
| author | Bushra Gul Maria Sana Aneela Saleem Zia Ul Mustafa Muhammad Salman Yusra Habib Khan Tauqeer Hussain Mallhi Tiyani Milta Sono Johanna C. Meyer Brian B. Godman |
| author_facet | Bushra Gul Maria Sana Aneela Saleem Zia Ul Mustafa Muhammad Salman Yusra Habib Khan Tauqeer Hussain Mallhi Tiyani Milta Sono Johanna C. Meyer Brian B. Godman |
| author_sort | Bushra Gul |
| collection | DOAJ |
| description | Antibiotics are one of the most frequently dispensed classes of medicines. However, excessive misuse and abuse enhances antimicrobial resistance (AMR). Previous studies in Pakistan have documented extensive dispensing of ‘Watch’ and ‘Reserve’ antibiotics, which is a concern. In view of this, there is a need to assess current dispensing patterns following COVID-19 in Pakistan. A cross-sectional study was undertaken, collecting dispensing data from 39 pharmacies and 53 drug stores from November 2022 to February 2023. Outlets were principally in urban areas (60.9%), with pharmacists/pharmacy technicians present in 32.6% of outlets. In total, 11,092 prescriptions were analyzed; 67.1% of patients were supplied at least one antimicrobial, 74.3% antibiotics, 10.2% antifungals and 7.9% anthelmintics. A total of 33.2% of antimicrobials were supplied without a prescription. Common indications for dispensed antibiotics were respiratory (34.3%) and gastrointestinal (16.8%) infections, which can be self-limiting. In addition, 12% of antibiotics were dispensed for the prevention or treatment of COVID-19. The most frequent antibiotics dispensed were ceftriaxone (18.4%) and amoxicillin (15.4%). Overall, 59.2% antibiotics were ‘Watch’ antibiotics, followed by ‘Access’ (40.3%) and ‘Reserve’ (0.5%) antibiotics. Of the total antibiotics dispensed for treating COVID-19, 68.3% were ‘Watch’ and 31.7% ‘Access’. Overall, there appeared to be an appreciable number of antibiotics dispensed during the recent pandemic, including for patients with COVID-19, alongside generally extensive dispensing of ‘Watch’ antibiotics. This needs to be urgently addressed with appropriate programs among pharmacists/pharmacy technicians to reduce AMR. |
| first_indexed | 2024-03-11T02:50:35Z |
| format | Article |
| id | doaj.art-531f883315e04ba7b76f67318d3a2320 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T02:50:35Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-531f883315e04ba7b76f67318d3a23202023-11-18T09:00:54ZengMDPI AGAntibiotics2079-63822023-06-01126101810.3390/antibiotics12061018Antimicrobial Dispensing Practices during COVID-19 and the Implications for PakistanBushra Gul0Maria Sana1Aneela Saleem2Zia Ul Mustafa3Muhammad Salman4Yusra Habib Khan5Tauqeer Hussain Mallhi6Tiyani Milta Sono7Johanna C. Meyer8Brian B. Godman9Department of Medicines, Tehsil Head Quarter (THQ) Hospital, District Bhakkar, Darya Khan 3000, Punjab, PakistanDepartment of Medicine, Faisalabad Medical University, Faisalabad 38000, Punjab, PakistanDepartment of Medicine, Faisalabad Medical University, Faisalabad 38000, Punjab, PakistanDiscipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, MalaysiaInstitute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Punja, PakistanDepartment of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi ArabiaDepartment of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, Gauteng, South AfricaDepartment of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, Gauteng, South AfricaDepartment of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, Gauteng, South AfricaAntibiotics are one of the most frequently dispensed classes of medicines. However, excessive misuse and abuse enhances antimicrobial resistance (AMR). Previous studies in Pakistan have documented extensive dispensing of ‘Watch’ and ‘Reserve’ antibiotics, which is a concern. In view of this, there is a need to assess current dispensing patterns following COVID-19 in Pakistan. A cross-sectional study was undertaken, collecting dispensing data from 39 pharmacies and 53 drug stores from November 2022 to February 2023. Outlets were principally in urban areas (60.9%), with pharmacists/pharmacy technicians present in 32.6% of outlets. In total, 11,092 prescriptions were analyzed; 67.1% of patients were supplied at least one antimicrobial, 74.3% antibiotics, 10.2% antifungals and 7.9% anthelmintics. A total of 33.2% of antimicrobials were supplied without a prescription. Common indications for dispensed antibiotics were respiratory (34.3%) and gastrointestinal (16.8%) infections, which can be self-limiting. In addition, 12% of antibiotics were dispensed for the prevention or treatment of COVID-19. The most frequent antibiotics dispensed were ceftriaxone (18.4%) and amoxicillin (15.4%). Overall, 59.2% antibiotics were ‘Watch’ antibiotics, followed by ‘Access’ (40.3%) and ‘Reserve’ (0.5%) antibiotics. Of the total antibiotics dispensed for treating COVID-19, 68.3% were ‘Watch’ and 31.7% ‘Access’. Overall, there appeared to be an appreciable number of antibiotics dispensed during the recent pandemic, including for patients with COVID-19, alongside generally extensive dispensing of ‘Watch’ antibiotics. This needs to be urgently addressed with appropriate programs among pharmacists/pharmacy technicians to reduce AMR.https://www.mdpi.com/2079-6382/12/6/1018COVID-19dispensingantimicrobialsantibioticscommunity pharmacistsindications |
| spellingShingle | Bushra Gul Maria Sana Aneela Saleem Zia Ul Mustafa Muhammad Salman Yusra Habib Khan Tauqeer Hussain Mallhi Tiyani Milta Sono Johanna C. Meyer Brian B. Godman Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan Antibiotics COVID-19 dispensing antimicrobials antibiotics community pharmacists indications |
| title | Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan |
| title_full | Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan |
| title_fullStr | Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan |
| title_full_unstemmed | Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan |
| title_short | Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan |
| title_sort | antimicrobial dispensing practices during covid 19 and the implications for pakistan |
| topic | COVID-19 dispensing antimicrobials antibiotics community pharmacists indications |
| url | https://www.mdpi.com/2079-6382/12/6/1018 |
| work_keys_str_mv | AT bushragul antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT mariasana antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT aneelasaleem antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT ziaulmustafa antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT muhammadsalman antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT yusrahabibkhan antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT tauqeerhussainmallhi antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT tiyanimiltasono antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT johannacmeyer antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan AT brianbgodman antimicrobialdispensingpracticesduringcovid19andtheimplicationsforpakistan |