TY - JOUR
T1 - Selling antibiotics without prescriptions among community pharmacies and drug outlets
T2 - a simulated client study from Ghana
AU - Ngyedu, Eric Kofi
AU - Acolatse, Joseph
AU - Akafity, George
AU - Incoom, Robert
AU - Rauf, Audu
AU - Seaton, R. Andrew
AU - Sneddon, Jacqueline
AU - Cameron, Elaine
AU - Watson, Margaret
AU - Wanat, Marta
AU - Godman, Brian
AU - Kurdi, Amanj
PY - 2023/11/24
Y1 - 2023/11/24
N2 - BackgroundSelling antibiotics without prescriptions is mostly illegal worldwide, including in Ghana, and promotes antimicrobial resistance. We evaluated the prevalence and practice of selling antibiotics without prescriptions among community pharmacies (CPs) and drug outlets, for the first time, in Ghana to quantify and characterize this issue to inform future interventions.Research design and methodsTwo scenarios utilizing the Simulated Client Methodology were enacted: an upper respiratory tract infection of viral origin (scenario one); and pediatric diarrhea (scenario two). CPs/Outlets were selected by stratified proportional random sampling from four metropolitan cities (~14% of the total Ghanaian population). Selling of antibiotics was assessed at three demand levels and its overall prevalence was estimated, then stratified by the study variables.ResultsOut of the 265 sampled CPs/outlets, the prevalence of selling antibiotic without prescription was 88.3% (n = 234/265), with variations not only across the four regions [92.5% (n = 123/133) in Kumasi, 87.5% (n = 14/16) in Cape Coast, 84.1% (n = 69/82) in Accra, and 82.4% (n = 28/34) in Tamale] but also across CPs [90% (n = 121/134)] and drug outlets [86% (n = 113/131)].ConclusionsA very high prevalence/sub-optimal practice of selling antibiotics without prescriptions was found. This highlights the need to increase compliance with antibiotic dispensing legislation through evidence-based interventions including education of key stakeholders.
AB - BackgroundSelling antibiotics without prescriptions is mostly illegal worldwide, including in Ghana, and promotes antimicrobial resistance. We evaluated the prevalence and practice of selling antibiotics without prescriptions among community pharmacies (CPs) and drug outlets, for the first time, in Ghana to quantify and characterize this issue to inform future interventions.Research design and methodsTwo scenarios utilizing the Simulated Client Methodology were enacted: an upper respiratory tract infection of viral origin (scenario one); and pediatric diarrhea (scenario two). CPs/Outlets were selected by stratified proportional random sampling from four metropolitan cities (~14% of the total Ghanaian population). Selling of antibiotics was assessed at three demand levels and its overall prevalence was estimated, then stratified by the study variables.ResultsOut of the 265 sampled CPs/outlets, the prevalence of selling antibiotic without prescription was 88.3% (n = 234/265), with variations not only across the four regions [92.5% (n = 123/133) in Kumasi, 87.5% (n = 14/16) in Cape Coast, 84.1% (n = 69/82) in Accra, and 82.4% (n = 28/34) in Tamale] but also across CPs [90% (n = 121/134)] and drug outlets [86% (n = 113/131)].ConclusionsA very high prevalence/sub-optimal practice of selling antibiotics without prescriptions was found. This highlights the need to increase compliance with antibiotic dispensing legislation through evidence-based interventions including education of key stakeholders.
KW - antimicrobial resistance
KW - antibiotic self-purchasing
KW - OTC antibiotic sale
KW - community drug outlets
KW - illegal antibiotic sales
KW - simulated client
U2 - 10.1080/14787210.2023.2283037
DO - 10.1080/14787210.2023.2283037
M3 - Article
SN - 1478-7210
VL - 21
SP - 1373
EP - 1382
JO - Expert Review of Anti-infective Therapy
JF - Expert Review of Anti-infective Therapy
IS - 12
ER -
