“Global review finds antibiotics frequently supplied without prescription”

“About three in four antibiotic requests and three in five consultations in community pharmacies around the world result in the sale of antibiotics without a prescription, according to a systematic review and meta-analysis published yesterday in the Journal of Infection.

In a review of 38 studies published from 2000 through 2017 on the frequency of non-prescription sale and supply of antibiotics in community pharmacies in 24 countries, an international team of researchers found that the overall pooled proportion of non-prescription supply of antibiotics following a patient request was 78%, and the non-prescription supply of antibiotics based on community pharmacy staff recommendation was 58%. Antibiotics were most commonly supplied to patients with symptoms of urinary tract infections (68%), upper respiratory tract infections (67%), and gastroenteritis (63%). Penicillins, fluoroquinolones, and macrolides, respectively, were the most commonly supplied antibiotics for these conditions.

Although all included countries, with the exception of one, classified antibiotics as prescription-only medicines, the overall pooled estimate of non-prescription supply of antibiotics was 62%, with non-prescription antibiotics being sold most frequently in community pharmacies in Indonesia (91%), Syria (87%), Saudi Arabia (85%), and Ethiopia (85%). Among regions, the supply of non-prescription antibiotics was highest in Latin America (78%).

“Despite the limitation of our review, the findings suggest that antibiotics are frequently supplied without prescription in many countries even where this supply remains illegal,” the authors conclude. “This overuse of antibiotics could facilitate the development and spread of antibiotic resistance.”

They add that while the findings underscore the need for countries to enforce laws that limit the supply of antibiotics without prescription in community pharmacies, they also highlight the role that community pharmacists, who are the first point of healthcare contact for patients in many countries, could play in promoting prudent antibiotic use.”

Source: CIDRAP