Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study
Introduction Resistant strains of bacteria are rapidly emerging with increasing inappropriate use of antibiotics rendering them less efficacious. Self-purchasing of antibiotics particularly for viral infections is a key driver of inappropriate use, especially in lower- and middle-income countries. T...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-12-01
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| Series: | Journal of Pharmaceutical Policy and Practice |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1186/s40545-020-00233-3 |
| _version_ | 1797401298506612736 |
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| author | Zikria Saleem Mohamed Azmi Hassali Brian Godman Munazzah Fatima Zeenia Ahmad Areeba Sajid Inaam Ur Rehman Muhammad Umer Nadeem Zaida Javaid Madeeha Malik Azhar Hussain |
| author_facet | Zikria Saleem Mohamed Azmi Hassali Brian Godman Munazzah Fatima Zeenia Ahmad Areeba Sajid Inaam Ur Rehman Muhammad Umer Nadeem Zaida Javaid Madeeha Malik Azhar Hussain |
| author_sort | Zikria Saleem |
| collection | DOAJ |
| description | Introduction Resistant strains of bacteria are rapidly emerging with increasing inappropriate use of antibiotics rendering them less efficacious. Self-purchasing of antibiotics particularly for viral infections is a key driver of inappropriate use, especially in lower- and middle-income countries. There is a particular issue in countries such as Pakistan. Consequently, there is a need to assess current rates of self-purchasing especially for reserve antibiotics to guide future policies. Aims Assess the extent of current antibiotic sales without a prescription in urban areas of Pakistan. Methodology A multicenter cross-sectional study was conducted in different areas of Punjab, Pakistan using Simulated Client technique. The investigators demanded different predefined antibiotics from WHO AWaRe groups without prescription. Three levels of demand were used to convince the pharmacy staff in order to dispense the antibiotic without a prescription. A data collection form was completed by simulated clients within 15 min of each visit. Results Overall 353 pharmacies and medical stores were visited out of which 96.9% pharmacies and medical stores dispensed antibiotics without demanding a prescription (82.7% at demand level 1 and 14.2% at demand level 2), with only 3.1% of pharmacies refusing to dispense antibiotics. The most frequently dispensed antibiotic was ciprofloxacin (22.1%). Surprisingly, even the reserve group antibiotics were also dispensed without a prescription. In only 25.2% visits, pharmacy staff guided patients about the use of antibiotics, and in only 11.0% pharmacists enquired about other medication history. Conclusion Currently, antibiotics are easily acquired without a legitimate prescription in Pakistan. There is a need for strict adherence to regulations combined with a multi-dimensional approach to enhance appropriate dispensing of antibiotics and limit any dispensing of WHO restricted antibiotics without a prescription. |
| first_indexed | 2024-03-09T02:07:54Z |
| format | Article |
| id | doaj.art-ba40f6339f804e53aea354b5ec69eb3a |
| institution | Directory Open Access Journal |
| issn | 2052-3211 |
| language | English |
| last_indexed | 2024-03-09T02:07:54Z |
| publishDate | 2020-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Pharmaceutical Policy and Practice |
| spelling | doaj.art-ba40f6339f804e53aea354b5ec69eb3a2023-12-07T15:28:02ZengTaylor & Francis GroupJournal of Pharmaceutical Policy and Practice2052-32112020-12-0113110.1186/s40545-020-00233-312315150Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client studyZikria Saleem0Mohamed Azmi Hassali1Brian Godman2Munazzah Fatima3Zeenia Ahmad4Areeba Sajid5Inaam Ur Rehman6Muhammad Umer Nadeem7Zaida Javaid8Madeeha Malik9Azhar Hussain10School of Pharmaceutical Sciences,School of Pharmaceutical Sciences,School of Pharmaceutical Sciences,University College of Pharmacy,University College of Pharmacy,University College of Pharmacy,University College of Pharmacy,University College of Pharmacy,Punjab Institute of Cardiology,Hamdard Institute of Pharmaceutical Sciences,Hamdard Institute of Pharmaceutical Sciences,Introduction Resistant strains of bacteria are rapidly emerging with increasing inappropriate use of antibiotics rendering them less efficacious. Self-purchasing of antibiotics particularly for viral infections is a key driver of inappropriate use, especially in lower- and middle-income countries. There is a particular issue in countries such as Pakistan. Consequently, there is a need to assess current rates of self-purchasing especially for reserve antibiotics to guide future policies. Aims Assess the extent of current antibiotic sales without a prescription in urban areas of Pakistan. Methodology A multicenter cross-sectional study was conducted in different areas of Punjab, Pakistan using Simulated Client technique. The investigators demanded different predefined antibiotics from WHO AWaRe groups without prescription. Three levels of demand were used to convince the pharmacy staff in order to dispense the antibiotic without a prescription. A data collection form was completed by simulated clients within 15 min of each visit. Results Overall 353 pharmacies and medical stores were visited out of which 96.9% pharmacies and medical stores dispensed antibiotics without demanding a prescription (82.7% at demand level 1 and 14.2% at demand level 2), with only 3.1% of pharmacies refusing to dispense antibiotics. The most frequently dispensed antibiotic was ciprofloxacin (22.1%). Surprisingly, even the reserve group antibiotics were also dispensed without a prescription. In only 25.2% visits, pharmacy staff guided patients about the use of antibiotics, and in only 11.0% pharmacists enquired about other medication history. Conclusion Currently, antibiotics are easily acquired without a legitimate prescription in Pakistan. There is a need for strict adherence to regulations combined with a multi-dimensional approach to enhance appropriate dispensing of antibiotics and limit any dispensing of WHO restricted antibiotics without a prescription.http://dx.doi.org/10.1186/s40545-020-00233-3antibioticssale without prescriptionsimulated clientpakistan |
| spellingShingle | Zikria Saleem Mohamed Azmi Hassali Brian Godman Munazzah Fatima Zeenia Ahmad Areeba Sajid Inaam Ur Rehman Muhammad Umer Nadeem Zaida Javaid Madeeha Malik Azhar Hussain Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study Journal of Pharmaceutical Policy and Practice antibiotics sale without prescription simulated client pakistan |
| title | Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study |
| title_full | Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study |
| title_fullStr | Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study |
| title_full_unstemmed | Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study |
| title_short | Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study |
| title_sort | sale of who aware groups antibiotics without a prescription in pakistan a simulated client study |
| topic | antibiotics sale without prescription simulated client pakistan |
| url | http://dx.doi.org/10.1186/s40545-020-00233-3 |
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