The impact of law enforcement on dispensing antibiotics without prescription: a multi-methods study from Saudi Arabia

Alian A. Alrasheedy, Muath A. Alsalloum, Feras A. Almuqbil, Muaath A. Almuzaini, Bandar S. Aba Alkhayl, Ahmed S. Albishri, Faisal F. Alharbi, Saleh R. Alharbi, Abdullah K. Alodhayb, Abubakr A. Alfadl, Brian Godman, Ruaraidh Hill, Mohammed S. Anaam

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Background: Dispensing of antibiotics without a prescription (DAwP) has been widely practised among community pharmacies in Saudi Arabia despite being illegal. However, in May 2018, the law and regulations were enforced alongside fines. Consequently, we wanted to evaluate the impact of these changes. Methods: A study was conducted among 116 community pharmacies in two phases. A pre-law enforcement phase between December 2017 and March 2018 and a post-law enforcement phase one year later. Each phase consisted of a cross-sectional questionnaire-based survey and a simulated client method (SCM) approach. In the SCM, clients presented with either pharyngitis or urinary tract infections (UTI). In SCM, for each phase, all 116 pharmacies were visited with one of the scenarios. Results: Before the law enforcement, 70.7% of community pharmacists reported that DAwP was common with 96.6% and 87.7% of participating pharmacies dispensed antibiotics without a prescription for pharyngitis and UTI respectively. After the law enforcement, only 12.9% reported that DAwP is still a common practice, with only 12.1% and 5.2% dispensing antibiotics without prescriptions for pharyngitis and UTI respectively. Conclusion: law enforcement was effective. However, there is still further scope for improvement. This could include further educational activities with pharmacists, physicians and the public.

Original languageEnglish
Pages (from-to)87-97
Number of pages11
JournalExpert Review of Anti-infective Therapy
Issue number1
Early online date13 Dec 2019
Publication statusPublished - 23 Dec 2019


  • dispensing antibiotics
  • community pharmacy
  • law enforcement
  • health policy
  • Saudi Arabia

Cite this