Asa Auta1, Muhammad Abdul Hadi2, Enoche Oga3, Emmanuel O Adewuyi4, Samirah N Abdu-Aguye5, Davies Adeloye6, Barry Strickland-Hodge7, Daniel J Morgan8. 1. School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, United Kingdom. Electronic address: aauta@uclan.ac.uk. 2. Leicester School of Pharmacy, De Montfort University, Hawthorn Building, Leicester LE1 9BH, United Kingdom. 3. School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, United Kingdom. 4. Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. 5. Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria. 6. Centre for Global Health Research and the World Health Organization Collaborating Centre for Population Health Research and Training, Usher Institute, University of Edinburgh, UK. 7. School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK. 8. Department of Epidemiology and Public Health, University of Maryland School of Medicine and the VA Maryland Healthcare System, Baltimore, MD, USA; Center for Disease Dynamics, Economics and Policy (CDDEP), Washington DC, USA.
Abstract
OBJECTIVE: To estimate the proportion of over-the-counter antibiotic requests or consultations that resulted in non-prescription supply of antibiotics in community pharmacies globally. METHODS: We systematically searched EMBASE, Medline and CINAHL databases for studies published from January 2000 to September 2017 reporting the frequency of non-prescription sale and supply of antibiotics in community pharmacies across the world. Additional articles were identified by checking reference lists and a Google Scholar search. A random effects meta-analysis was conducted to calculate pooled estimates of non-prescription supply of antibiotics. RESULTS: Of the 3302 articles identified, 38 studies from 24 countries met the inclusion criteria and were included in the review. All the included countries with the exception of one, classified antibiotics as prescription-only medicines. The overall pooled proportion of non-prescription supply of antibiotics was 62% (95% CI 53-72). The pooled proportion of non-prescription supply of antibiotics following a patient request was 78% (95% CI 59-97) and based on community pharmacy staff recommendation was 58% (95% CI 48-68). The regional supply of non-prescription antibiotics was highest in South America, 78% (95% CI 72-84). Antibiotics were commonly supplied without a prescription to patients with symptoms of urinary tract infections (68%, 95% CI 42-93) and upper respiratory tract infections (67%, 95% CI 55-79). Fluoroquinolones and Penicillins respectively were the most commonly supplied antibiotic classes for these indications. CONCLUSION: Antibiotics are frequently supplied without prescription in many countries. This overuse of antibiotics could facilitate the development and spread of antibiotic resistance.
OBJECTIVE: To estimate the proportion of over-the-counter antibiotic requests or consultations that resulted in non-prescription supply of antibiotics in community pharmacies globally. METHODS: We systematically searched EMBASE, Medline and CINAHL databases for studies published from January 2000 to September 2017 reporting the frequency of non-prescription sale and supply of antibiotics in community pharmacies across the world. Additional articles were identified by checking reference lists and a Google Scholar search. A random effects meta-analysis was conducted to calculate pooled estimates of non-prescription supply of antibiotics. RESULTS: Of the 3302 articles identified, 38 studies from 24 countries met the inclusion criteria and were included in the review. All the included countries with the exception of one, classified antibiotics as prescription-only medicines. The overall pooled proportion of non-prescription supply of antibiotics was 62% (95% CI 53-72). The pooled proportion of non-prescription supply of antibiotics following a patient request was 78% (95% CI 59-97) and based on community pharmacy staff recommendation was 58% (95% CI 48-68). The regional supply of non-prescription antibiotics was highest in South America, 78% (95% CI 72-84). Antibiotics were commonly supplied without a prescription to patients with symptoms of urinary tract infections (68%, 95% CI 42-93) and upper respiratory tract infections (67%, 95% CI 55-79). Fluoroquinolones and Penicillins respectively were the most commonly supplied antibiotic classes for these indications. CONCLUSION: Antibiotics are frequently supplied without prescription in many countries. This overuse of antibiotics could facilitate the development and spread of antibiotic resistance.
Authors: Haniyyah J Majeed; Maria V Riquelme; Benjamin C Davis; Suraj Gupta; Luisa Angeles; Diana S Aga; Emily Garner; Amy Pruden; Peter J Vikesland Journal: Front Microbiol Date: 2021-05-13 Impact factor: 5.640