Dispensing pattern for acute non‐infectious diarrhoea in children at community pharmacies in Thailand

Jaisue, Siriluk; Phomtavong, Sommaly; Eua‐anant, Sasithorn; Borlace, Glenn N.

doi:10.1002/jppr.1345

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…Further, the majority of Sri Lankan pharmacy students reported that antibiotics consumption is appropriate for sore throat and diarrhoea in contrast to Australian students. This suggests a potential for antibiotic overuse, as the majority of diarrhoea illnesses do not require antibiotic therapy [ 36 ]. Similarly illnesses involving a sore throat do not usually require antibiotic therapy as it is most commonly a self-limiting viral illness [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

A comparative study regarding antibiotic consumption and knowledge of antimicrobial resistance among pharmacy students in Australia and Sri Lanka

Sakeena

Bennett²,

Carter

et al. 2019

PLoS ONE

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IntroductionAntimicrobial resistance (AMR) is a major global health challenge. Pharmacists play a key role in the health care setting to support the quality use of medicines. The education and training of pharmacy students have the potential to impact on patterns of antibiotic use in community and hospital settings. The aim of this study was to investigate and compare antibiotic use and knowledge of antibiotics and AMR among undergraduate pharmacy students in Australian and Sri Lankan universities.MethodsA cross-sectional survey was conducted in Australian and Sri Lankan universities that offer a pharmacy degree. A paper-based survey was utilised in Sri Lanka and an identical survey distributed online among pharmacy students in Australia. Descriptive and comparative data analyses were performed.Results476 pharmacy students from 14 universities in Australia and 466 students from 6 universities in SL completed the survey. Participants commonly reported previous antibiotic use [Australia (88%) and Sri Lanka (86%)]. The majority of students [Australia (89%) and Sri Lanka (77%)] reported they obtained antibiotics with a prescription. Australian pharmacy students correctly reported regarding optimal antibiotic use for certain disease conditions when compared to Sri Lankan students (P<0.05). A greater antibiotic knowledge level regarding AMR was found among Australian students compared to Sri Lankan students (p<0.05).ConclusionThis study provides an understanding about antibiotic consumption and knowledge on AMR among pharmacy students in a developed country, Australia and a developing country, Sri Lanka. These findings identify possible misconceptions about antibiotics and a lower level of knowledge of AMR amongst Sri Lankan undergraduate pharmacy students. Future research should focus on implementation of a strategic education plan for undergraduate pharmacy students in Sri Lankan universities. The curricula of pharmacy courses in Australian universities may inform such a plan.

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Section: Discussionmentioning

confidence: 99%

A comparative study regarding antibiotic consumption and knowledge of antimicrobial resistance among pharmacy students in Australia and Sri Lanka

Sakeena

Bennett²,

Carter

et al. 2019

PLoS ONE

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“…Three articles conducted in Tanzania and Thailand [20][21][22] presented the percentage of antibiotic dispensing without a prescription related to class I, legally authorized to dispense antibiotics without prescription and class II that only sell them with a medical prescription. Two [20,22] of these articles presented the percentage related to the two pharmacy classes, while 1 article [21] only presented the percentage related to class I pharmacies. By comparing the percentages presented linked to both types of pharmacy, it is possible to verify that a higher percentage is related to the type II pharmacies in the two articles presented.…”

Section: Frequency Of Antibiotic Dispensation Without a Prescriptionmentioning

confidence: 99%

Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review

et al. 2020

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Antibiotic resistance still remains a major global public health problem and the dispensing of antibiotics without a prescription at community pharmacies is an important driver of this. MEDLINE, Pubmed and EMBASE databases were used to search and identify studies reporting the dispensing of non-prescribed antibiotics in community pharmacies or drugstores that sell drugs for human use, by applying pharmacy interviews/questionnaires methods and/or simulated patient methods. Of the 4683 studies retrieved, 85 were included, of which 59 (69.4%) were published in low-and middle-income countries. Most of the papers (83.3%) presented a percentage of antibiotic dispensing without a prescription above 60.0%. Sixty-one studies evaluated the active substance and the most sold antibiotics without a prescription were amoxicillin (86.9%), azithromycin (39.3%), ciprofloxacin (39.3%), and amoxicillin-clavulanic acid (39.3%). Among the 65 articles referencing the diseases/symptoms, this practice was shown to be mostly associated with respiratory system problems (100.0%), diarrhea (40.0%), and Urinary Tract Infections (30.8%). In sum, antibiotics are frequently dispensed without a prescription in many countries and can thus have an important impact on the development of resistance at a global level. Our results indicate the high need to implement educational and/or regulatory/administrative strategies in most countries, aiming to reduce this practice.

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“…On the supply side, economic challenges and market competition, combined with widespread availability of cheap antibiotics and lack of adequate information on AMR, induced pharmacies to sell nonprescribed antibiotics. While some of these issues have been highlighted in previous work in Indonesia [18,33] and elsewhere in Asia [34][35][36][37][38], a key finding in our study is that policy reforms to improve access to affordable services and medicines may have unintended and undesirable effects on pharmacy practice and, ultimately, the control of AMR. Since the introduction of the JKN in 2014, a substantial increase in the utilisation of public health centres has been reported [39].…”

Section: Discussionmentioning

confidence: 74%

Community pharmacies, drug stores, and antibiotic dispensing in Indonesia: a qualitative study

et al. 2021

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Background Inappropriate dispensing of antibiotics at community pharmacies is an important driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Thus, a better understanding of dispensing practices is crucial to inform national, regional, and global responses to AMR. This requires careful examination of the interactions between vendors and clients, sensitive to the context in which these interactions take place. Methods In 2019, we conducted a qualitative study to examine antibiotic dispensing practices and associated drivers in Indonesia, where self-medication with antibiotics purchased at community pharmacies and drug stores is widespread. Data collection involved 59 in-depth interviews with staff at pharmacies and drug stores (n = 31) and their clients (n = 28), conducted in an urban (Bekasi) and a semi-rural location (Tabalong) to capture different markets and different contexts of access to medicines. Interview transcripts were analysed using thematic content analysis. Results A common dispensing pattern was the direct request of antibiotics by clients, who walked into pharmacies or drug stores and asked for antibiotics without prescription, either by their generic/brand name or by showing an empty package or sample. A less common pattern was recommendation to use antibiotics by the vendor after the patient presented with symptoms. Drivers of inappropriate antibiotic dispensing included poor knowledge of antibiotics and AMR, financial incentives to maximise medicine sales in an increasingly competitive market, the unintended effects of health policy reforms to make antibiotics and other essential medicines freely available to all, and weak regulatory enforcement. Conclusions Inappropriate dispensing of antibiotics in community pharmacies and drug stores is the outcome of complex interactions between vendors and clients, shaped by wider and changing socio-economic processes. In Indonesia, as in many other LMICs with large and informal private sectors, concerted action should be taken to engage such providers in plans to reduce AMR. This would help avert unintended effects of market competition and adverse policy outcomes, as observed in this study.

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Dispensing pattern for acute non‐infectious diarrhoea in children at community pharmacies in Thailand

Cited by 9 publications

References 13 publications

A comparative study regarding antibiotic consumption and knowledge of antimicrobial resistance among pharmacy students in Australia and Sri Lanka

A comparative study regarding antibiotic consumption and knowledge of antimicrobial resistance among pharmacy students in Australia and Sri Lanka

Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review

Community pharmacies, drug stores, and antibiotic dispensing in Indonesia: a qualitative study

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