RESUMO
<b>Objectives:</b> The patterns of purchasing prescription antimicrobials with or without a prescription from retail pharmacies in Ulaanbaatar, Mongolia, were examined in relation to purchasers’ socioeconomic status and price of the product.<br><b>Methods:</b> A survey was conducted at 250 randomly selected pharmacies in Ulaanbaatar. A total of 619 customers were interviewed, and the medicines they bought at the stores were examined by medical doctors. The use of prescriptions and advice in purchasing medicines and sociodemographic characteristics of the subjects were determined.<br><b>Results:</b> Interviews were conducted with 297 customers who purchased prescription antimicrobials in front of the store in which they made their purchase. Among these 297 customers, only 19.5% (<i>n</i>=58) purchased medicine with a formal prescription, and 37.4% (<i>n</i>=111) purchased medicines on their own initiative and without the guidance of medical professionals. Purchase without a prescription was not associated with the subjects’ gender, age, educational status or area of residence. Lower-priced antimicrobials were purchased without prescriptions more frequently than those with a higher price (<i>P</i><0.05).<br><b>Conclusion:</b> The purchase of antimicrobials without prescriptions is common across all sociodemographic strata in Ulaanbaatar, Mongolia. Considering the increases in number of retail pharmacies and in sales of antimicrobials associated with economic development, measures to enforce regulations and to promote education among the general public and pharmacy professionals are required.
RESUMO
OBJECTIVE: To examine the inappropriate use of antimicrobials by investigating (1) actual utilization pattern and retail sales and (2) antimicrobial resistant information provided by health professionals in Ulaanbaatar, Mongolia. METHODS: We investigated antimicrobial use in Ulaanbaatar, Mongolia by surveying 619 consenting customers who attended 250 randomly chosen pharmacies in December 2006. Pharmacy staff were also interviewed about antimicrobials purchased. In January 2007, we surveyed 117 consenting Ulaanbaatar medical doctors from seven local hospitals about their perceptions of treatment failure due to antimicrobial resistance. RESULTS: Among 619 pharmacy customers, 48% of them had bought at least one type of antimicrobial medicine and, of these, 42% had a prescription to purchase antimicrobials. On average, 67% of the customers reported that a pharmacy worker had given them information regarding the dose and timing at which the medicine should be used but only 9% reported that they had been given information regarding possible adverse effects. The survey of medical doctors suggested that some antibiotics had become less effective clinically between 2001 and 2006. CONCLUSION: The study shows that less than half of all customers who purchased an antibiotic at a pharmacy had a prescription. This shows that antimicrobials can be readily purchased without a prescription despite the existence of laws making such practices illegal. There is a need to establish a vigilant drug regulatory authority to promote enforcement and regulation of medicines in Mongolia. To create awareness regarding the dangers of antimicrobial resistance, educational campaigns for consumers are also necessary.
