Pattern of antibiotic dispensing at pharmacies according to access, watch, reserve (AWaRe) classification: multicenter study after COVID-19 waves in different districts of Pakistan
Abstract Objective The dispensing of non-prescription antibiotics is a worldwide concern, and antibiotics should only be dispensed with a legitimate prescription. Methodology A cross-sectional study was conducted using the simulated client methodology, with data collected, recorded, and analyzed usi...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
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| Series: | BMC Research Notes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13104-024-07030-0 |
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| Summary: | Abstract Objective The dispensing of non-prescription antibiotics is a worldwide concern, and antibiotics should only be dispensed with a legitimate prescription. Methodology A cross-sectional study was conducted using the simulated client methodology, with data collected, recorded, and analyzed using SPSS. Results The simulated client visited 210 pharmacies, of which 70 dispensed antibiotics without a prescription. Outcomes The most often suggested antibiotics for upper respiratory tract infections (URTIs) were Amoxicillin (n = 17, 8.1%), Clarithromycin (n = 20, 9.5%), and Moxifloxacin (n = 13, 6.2%), with 33.3% of medications dispensed without a prescription for URTIs. Cefixime (n = 20, 9.5%) and ceftriaxone (n = 17, 8.1%) were the most often administered medications for urinary tract infections (UTIs). The non-prescribed dispensing of upper respiratory tract infections (URTIs) and urinary tract infections (UTIs) was markedly elevated (p < 0.05). Antibiotics were dispensed without a prescription for diarrheal diseases in over 50% of pharmacies, with Metronidazole (n = 23, 11%), Azithromycin (n = 16, 7.6%), and Rifaximin (n = 15, 7.1%) being the most often prescribed. In all bivariate and multivariate models, male gender was associated with reduced likelihood (COR: 0.30, 95% CI: 0.12–0.72; p = 0.0079 and AOR: 0.03, 95% CI: 0.005–0.15; p = 0.0001). Individuals aged 30 years and older exhibited increased odds of dispensing in both bivariate (COR: 3.67, 95% CI: 1.69–8.87; p = 0.0018) and multivariate analyses (AOR: 9.44, 95% CI: 2.55–61.70; p = 0.001). The presence of a pharmacist on duty markedly diminished the likelihood of administering antibiotics without a prescription (COR: 0.13, 95% CI: 0.06–0.25; p = < 0.001; AOR: 0.06, 95% CI: 0.03–0.16; p = < 0.001). Conclusion These findings highlight the imperative of enforcing existing laws and implementing rigorous rules, alongside pharmacy-centered antimicrobial stewardship programs that focus on accurate dispensing practices to mitigate antimicrobial resistance. |
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| ISSN: | 1756-0500 |