Evaluation of antibiotic dispensing practice in community pharmacies in Jordan: A cross sectional study

Abstract

It is well known that the emergence of antibiotic resistance is linked to the misuse and overuse of antibiotics. Misuse includes self-medication and the inappropriate use of antibiotics because of improper dosage or improper duration than recommended. This study investigated three patterns of dispensing antibiotics in a sample of community pharmacies in Jordan. This included dispensing antibiotics by prescription or over-the-counter either by direct request or upon a pharmacist’s recommendation. The antibiotics dispensed were evaluated in terms of indication, appropriateness of dose, and duration of treatment based on the empirical treatment suggested by selected references: Lexicomp (2017) and UptoDate (2017) and the manufacturer’s recommendations. Of the 457 antibiotics dispensed, almost one third were without prescription. Of the antibiotics dispensed with prescription or without prescription, 31.5% and 24.6% respectively were appropriate dosage and duration ( p = 0.002). In the three patterns of dispensing, beta lactam antibiotics were the most commonly dispensed. In addition, it was noticed that there was a tendency to prescribe or dispense higher generations of antibiotics to cases that could have been treated with lower generation or safer antibiotics. Furthermore, 12.2% of the antibiotics were dispensed to treat infections that are not indicated for them. In conclusion, a significant proportion of antibiotics are dispensed without prescription in Jordan. Moreover, a considerable proportion of prescribed antibiotics were inappropriate for the conditions concerned. This indicates the importance of enforcing the Jordanian regulations prohibiting the dispensing of nonprescription antibiotics and the implementation of continuous education to physicians and pharmacists to increase awareness about the emergence of antibiotic resistance.

Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting

“…A four-month observational study in Jordan found that less than 70% of antibiotics dispensed were physician prescribed, and only 31.5% of those drugs were prescribed at the correct dosage and for the correct duration. Lower socioeconomic status and poor education were driving factors for self-medication, which was consistent with similar studies [72,73]. A cross-sectional, client simulation study in Surabaya, Indonesia, investigated common dispensation practices in the country.…”

Declining prevalence of Helicobacter pylori infection in Jordanian children, report from developing country

“…Almaayta and colleagues [ 42 ] reported that of 202 pharmacies visited, 150 dispensed antibiotics without a prescription, mainly for the treatment of sore throat, urinary symptoms, and diarrhea. Another study reported that one third of antibiotics dispensed at local pharmacies were unprescribed [ 43 ]. A cross-sectional study from Irbid done by Yusef and colleagues reported that almost 40% of the participants who received antibiotics did not have a prescription [ 44 ].…”

Outpatient Antibiotic Dispensing for the Population with Government Health Insurance in Syria in 2018–2019

“…In Europe and North America, outpatient antibiotic dispensing (OAD) is often prescription-only [ 3 ] but can be accessed without prescriptions in many countries of the global South [ 4 , 5 ]. In 1988, Syria’s Ministry of Health legislated to determine which drugs could be sold over-the-counter.…”