Antibiotic dispensation by Lebanese pharmacists: a comparison of higher and lower socio-economic levels

ABSTRACT

Indiscriminate use of antibiotics contributes to a global spread of antimicrobial resistance. Previous studies showed an excessive consumption of antibiotics purchased without medical prescription from community pharmacies, mainly in developing countries. There is a shortage of studies revealing the role of community pharmacists in the overuse of antibiotics. Our objective is to study the dispensing policy of non-medical prescription antibiotics in community pharmacies, assessing the possible influence of the socio-economic level of the area over this practice. A cross-sectional study was conducted between February and May 2011 among 100 pharmacists working in Beirut's pharmacies and its suburbs. Pharmacies were divided into 2 groups according to the socio-economic level of the population living in the pharmacy area. A self-administered questionnaire was filled by pharmacists. Over-the-counter antibiotic availability existed in both higher and lower socio-economic areas on the whole, 32% of antibiotics were dispensed without medical prescription, with higher frequency in lower socio-economic areas [p = 0.003]. Dispensing injectable antibiotics without medical prescription was significantly higher in lower socio-economic areas [p = 0.021], as well as dispensing an association of 2 antibiotics without medical prescription [p = 0.001]. Pharmacists working in lower socio-economic areas recommended more frequent antibiotics to children and the elderly [p < 0.001 and p = 0.004, respectively]. Dispensing antibiotics without medical prescription in Beirut community pharmacies is a common practice, particularly in lower socioeconomic areas. This public health problem should be addressed at the social, educational, and legislative levels