Dispensing of antimicrobials in Kenya: A cross-sectional pilot study and its implications

Abstract

Objective:The objective of this study was to evaluate the extent of self-medication of antibiotics and dispensing practices in Kenya.Methods:A cross-sectional study was carried out at three selected pharmacies in Nairobi (Kenya), between January and March 2017, targeting principally antibiotic prescriptions for systemic use issued and dispensed as well as antibiotics sold over-the-counter without a prescription. The quality of antibiotics prescribed and dispensed was assessed against key WHO and other criteria. Benchmarking was used to assess the quality of antibiotics prescribed as there are no predetermined levels, just guidance and the rationale. Key indicators included: utilization of penicillins, percentage utilization of third-and fourth-generation of cephalosporins versus first and second generation, utilization of macrolides including lincosamides and utilization of quinolones as a percent of total systemic antibiotic use.Findings:There was a low level of dispensing of antibiotics without a prescription with over 90% (94.1%) of antibiotics dispensed with a valid prescription. The most common antibiotics dispensed were the penicillins at just over 50% of all antibiotics, the cephalosporins at over 12% (12.6%) and the fluoroquinolones at just under 12% (11.7%). There were concerns with high use of third and fourth generation cephalosporins versus first- and second-generation as well as co-amoxiclav versus other penicillins.Conclusion:Low levels of self-medication of antibiotics and high adherence to quality standards for dispensing are encouraging and provide direction to other countries. Educational initiatives are needed though to address high levels of co-amoxiclav prescribing.

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

“…In the community, pharmacists have a vital role as they are often the first healthcare professional that patients contact regarding respiratory/ influenza diseases especially in countries with high patient co-payments, concerns with access to ambulatory healthcare facilities as well as issues of affordability to pay for a physician and their medicines ( Markovic-Pekovic et al., 2017 ; Mukokinya et al., 2018 ; Adunlin et al., 2020 ; Al-Quteimat and Amer, 2020 ; Godman et al., 2020a ). This includes encouraging self care/ hygiene measures including the supplying and wearing of masks and the need for regular hand washing as well as trying to protect patients against stock-outs of pertinent medicines ( Al-Quteimat and Amer, 2020 ; Amariles et al., 2020 ; Haque et al., 2020 ; Ung, 2020 )…”

Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study

“…Secondly, there is a need to educate pharmacists and their assistants about the appropriate management of infections typically seen in ambulatory care given concerns with their knowledge in a number of countries including Pakistan [ 32 , 50 , 53 , 55 , 84 , 85 ]. Studies have shown that educated pharmacists tend to dispense fewer antibiotics for suspected viral infections such as upper respiratory tract infections [ 56 , 86 , 87 ]. Where necessary, patients should be encouraged to visit physicians for their infection.…”

Availability and price changes of potential medicines and equipment for the prevention and treatment of COVID-19 among pharmacy and drug stores in Bangladesh; findings and implications

“…Pharmacists and others could also offer online or phone counseling services for patients, promote the rational use of medicines, and potentially offer vaccination services 130,135 . However, this may require improved professionalism among pharmacists and store owners [136][137][138] . Pharmacists and others also need to balance demand and supply of medicines, which is essential in countries with high patient copayments and existing concerns with the availability of medicines in healthcare facilities 126,139 .…”