ABSTRACT
Aims:The practice of antibiotic dispensing in community pharmacies may contribute to irrational use of antibiotics. The aim of this study was to evaluate the antibiotic dispensing patterns in community pharmacies of the Eastern DRCongo.Methods:It is a cross-sectional study carried out at Bukavu city. The study included 1504 subjects attending community pharmacies. Thus, a total number of 40 pharmacies were selected. The sociodemographic profiles of patients and dispensers were also recorded. The pharmacological interventions were investigated in terms of antibiotics dispensed according to patient’s complaints antibiotic dispensing with or without prescription, the substitution of antibiotics in prescriptions.Results: Participants attending pharmacies for antibiotic needs were in the mean age of 29.8±13 years. Most of the pharmacy workers consisted of pharmacy technicians (70%) and no trained dispensers (20%). Pharmacists represented only 10% of all dispensers in community pharmacies. We found that 67.8% of subjects purchased antibiotics without prescription. The antibiotics dispensed without prescription were either on patients’ requests (70.1%) or the suggestion of dispensers (29.9%). Only 18.4% of prescriptions were subject to substitution. The conditions for requiring antibiotic dispensing without prescriptions were respectively gastrointestinal (34%), respiratory (27%), genitourinary (25%), skin (11%) and dental (2%) infections. Conditions that were not well defined represented 1%. In cephalosporins, Cefixime was the most important drug dispensed without prescription (72.5%) whereas in penicillins, this was Amoxicillin (55.5%). Doxycycline was more dispensed in the class of cyclines (69.4%). Erythromycin (53.1%) and Azithromycin (29.4%) were more dispensed in the class of macrolides. Ciprofloxacin was the most dispensed drug in the class of quinolones (74.3%) and Metronidazole (86.8%) in the class of imidazoles. Conclusion:The Antibiotic dispensing practice is very critical in the community pharmacies of Bukavu city due to the lack of qualified dispensers. This may increase the antibiotic self-medication and contribute to antibiotic resistance
ABSTRACT
Background: Common cold is a self limited viral infection, which can be treated symptomatically without the need to antibiotics which are not effective or curative. This study aimed to evaluate the practices of community pharmacists in communicating, diagnosing, treating and counseling patients who are requesting antibiotics for their common cold treatment. Methods: A cross-sectional pilot exploratory study was done in Baghdad – Iraq at which a pharmacist acts as simulated person (SP) in order to collect the data. SP asks the pharmacist about the strongest antibiotic for common cold. SP observed and explored adherence of the pharmacist to law in dispensing over the counter (OTC) and prescription only medications (POM) drugs, patient’s counseling standards, and symptomatic diagnosis of common cold through using WWHAM (who is the patient, what are the symptoms, for how long, any action taken, any medication taken) technique. Results: More than 60% of pharmacists had failed to use WWHAM technique as a method for probing information about the patient and his/her case history. Furthermore there is a significant lack for asking the patients about their past medical history and drug allergy. 45% of Iraqi pharmacists supplied the SP with antibiotic for his common cold. Amoxicillin was the most commonly supplied (44.4%) antibiotic for common cold. Patients' counseling by pharmacists was mostly about the frequency of drug dosing. Conclusion: There are insufficient clinical and communication skills for Iraqi pharmacists who work in community pharmacies, this result not only in an irrational antibiotic dispensing but also in poor pharmacist's ability to counsel and educate the patient about the proper use of the dispensed medications.