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Prescription and non-prescription antibiotic dispensing practices in part I and part II pharmacies in Moshi Municipality, Kilimanjaro Region in Tanzania: A simulated clients approach.

Title: Prescription and non-prescription antibiotic dispensing practices in part I and part II pharmacies in Moshi Municipality, Kilimanjaro Region in Tanzania: A simulated clients approach.
Authors: Pius G Horumpende; Tolbert B Sonda; Marco van Zwetselaar; Magreth L Antony; Filemon F Tenu; Charles E Mwanziva; Elichilia R Shao; Stephen E Mshana; Blandina T Mmbaga; Jaffu O Chilongola
Source: PLoS ONE, Vol 13, Iss 11, p e0207465 (2018)
Publisher Information: Public Library of Science (PLoS)
Publication Year: 2018
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Medicine; Science
Description: Antibiotic dispensing without a prescription poses a threat to public health as it leads to excessive antibiotic consumption. Inappropriate antibiotic availability to the community has been documented to be amongst drivers of antimicrobial resistance emergence. Community pharmacies are a source of antibiotics in low and middle-income countries (LMICs). We aimed at assessing antibiotic dispensing practices by community pharmacy retailers in Moshi urban, Kilimanjaro, Tanzania and recommend interventions to improve practice. Using a Simulated Client (SC) Method, an observational cross-sectional survey of antibiotic dispensing practices was conducted from 10th June to 10th July 2017. Data analysis was done using Stata 13 (StataCorp, College Station, TX, USA). A total of 82 pharmacies were visited. Part I pharmacies were 26 (31.71%) and 56 (68.29%) were part II. Overall 92.3% (95% CI 77.8-97.6) of retailers dispensed antibiotics without prescriptions. The antibiotics most commonly dispensed without a prescription were ampiclox for cough (3 encounters) and azithromycin for painful urination (3 encounters). An oral third generation cephalosporin (cefixime) was dispensed once for painful urination without prescription by a part I pharmacy retailer. Out of 21, 15(71.43%) prescriptions with incomplete doses were accepted and had antibiotics dispensed. Out of 68, 4(5.9%) retailers gave instructions for medicine use voluntarily. None of the retailers voluntarily explained drug side-effects. In Moshi pharmacies, a high proportion of antibiotics are sold and dispensed without prescriptions. Instructions for medicine use are rarely given and none of the retailers explain side effects. These findings support the need for a legislative enforcement of prescription-only antibiotic dispensing rules and regulations. Initiation of clinician and community antibiotic stewardship and educational programs on proper antibiotic use to both pharmacists and public by the regulatory bodies are highly needed.
Document Type: article in journal/newspaper
Language: English
Relation: http://europepmc.org/articles/PMC6248976?pdf=render; https://doaj.org/toc/1932-6203; https://doaj.org/article/2bd589baa86f454b9cfdf797c3cb7431
DOI: 10.1371/journal.pone.0207465
Availability: https://doi.org/10.1371/journal.pone.0207465; https://doaj.org/article/2bd589baa86f454b9cfdf797c3cb7431
Accession Number: edsbas.75E2C3D
Database: BASE