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Sales of antibiotics without a prescription in pharmacies, 2017 and 2021, China.
Chen, Jie; Xie, Ying; Sun, Yiting; Zang, Ruichen; Sun, Yuhao; Dan, Lintao; Wang, Xuanding; Hesketh, Therese.
  • Chen J; Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou310058, China.
  • Xie Y; School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • Sun Y; Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou310058, China.
  • Zang R; Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou310058, China.
  • Sun Y; Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou310058, China.
  • Dan L; Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou310058, China.
  • Wang X; Department of Antimicrobial Stewardship, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
  • Hesketh T; Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou310058, China.
Bull World Health Organ ; 101(5): 317-325A, 2023 May 01.
Article in English | MEDLINE | ID: covidwho-2313592
ABSTRACT

Objective:

To measure sales of antibiotics without a prescription in pharmacies in China in 2017 and 2021, before and during the coronavirus disease 2019 (COVID-19) pandemic, and determine the factors associated with such sales.

Methods:

We conducted cross-sectional surveys using the simulated patient method in retail pharmacies in 13 provinces in eastern, central and western China in 2017 and 2021. At the pharmacies, the simulated patients (trained medical students) reported that they had mild respiratory tract symptoms and asked for treatment, using a three-stage process (i) request some treatment; (ii) request antibiotics; (iii) request specific antibiotics. We used multivariable logistic regression analysis to determine factors associated with sale of antibiotics without a prescription.

Findings:

Of the pharmacies visited in 2017, 83.6% (925/1106) sold antibiotics without a prescription; this figure was 78.3% (853/1090) in 2021 (P-value 0.002). After excluding pharmacies prohibited from selling antibiotics because of COVID-19, this difference was not significant (83.6% versus 80.9%; 853/1054; P-value 0.11). Factors significantly associated with selling antibiotics without a prescription in both 2017 and 2019 were location in central and western China compared with eastern China; being in a township or village compared with in a city; and presence of a counter where antibiotics were dispensed.

Conclusion:

Although laws became stricter between 2017 and 2021, antibiotic sales without a prescription were still common in pharmacies across China. Existing regulations need to be more strictly enforced, and pharmacy staff and the public should be made more aware of the risks of antibiotic misuse and dangers of antimicrobial resistance.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmacies / Anti-Bacterial Agents Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: Bull World Health Organ Year: 2023 Document Type: Article Affiliation country: BLT.22.289435

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmacies / Anti-Bacterial Agents Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: Bull World Health Organ Year: 2023 Document Type: Article Affiliation country: BLT.22.289435