The sale of antibiotics without prescription in pharmacies in Damascus, Syria

Al-Faham, Zaid; Habboub, Ghaith; Takriti, Farah

doi:10.3855/jidc.1248

Cited by 88 publications

(87 citation statements)

References 12 publications

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“…The driving factors that determined the pharmacists practices included keeping the pharmacy business, the relationship to the pharmacist, the patient's age, and pregnancy. Some of these factors are similar to the ones we found in other Arab countries 10 ; other factors are different from the ones found in other developing countries outside of the Arab world. 5,8,9 This was clearly obvious in all the scenarios proposed to our pharmacist interviewees.…”

Section: Discussionmentioning

confidence: 60%

“…An earlier study performed in the Syrian capital of Damascus found an alarming percentage of 89.3% of antibiotics are sold without a prescription. 10 Existing regulations do not include antibiotics as one of the categories of medications that can be dispensed without a prescription, however, there is no clear or strict regulations prohibiting the direct sale of antibiotics without a prescription. 14 All interviewed pharmacists felt comfortable dispensing antibiotics without a prescription.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, there is an implication that the sale of antibiotics without a prescription is prohibited, however, these regulations are not clearly stated or strictly enforced. 10,11 There are many factors that may contribute to the wide spreading of this practice including; lack of pharmacist's knowledge, poor legislations enforcement, customers' pressure, financial incentives from the pharmaceutical industry, and the business nature of the pharmacy. 15e18 Although this practice is unlawful, 14 it is common in Syria, 10 favored by the fact that it is not clearly punishable by law.…”

Section: Introductionmentioning

confidence: 99%

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A qualitative analysis of pharmacists' attitudes and practices regarding the sale of antibiotics without prescription in Syria

Bahnassi

2015

Journal of Taibah University Medical Sciences

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Objectives: Antibiotic resistance poses an alarming threat in antimicrobial therapy worldwide. This practice is widely spread in Syria as in other countries. This study aims to investigate the Syrian pharmacists' attitudes and practices in regard to antibiotic dispensing without prescription.Methods: Direct interview questions and five hypothetical scenarios were presented to 350 pharmacists in 3 major Syrian cities. Interview transcripts were prepared, coded, and categorized under 5 major themes using a computer software.Results: 147 pharmacists agreed to participate in our study. All pharmacists admit to dispense antibiotics without a prescription. Pharmacists were more likely to dispense antibiotics to their relatives, usual customers, and to patients who were prescribed the same antibiotic before. Most pharmacists did not agree that this practice posed a problem to patients welfare. The ones who agreed felt that more laws were needed and that the existing laws lacked enforcement. Conclusions:The results are quite alarming as our study shows that this practice will most probably continue to exist. Stricter laws and more law enforcement in addition to pharmacists and public education may constitute the most important elements to limit the spread of antibiotic dispensing without prescription in Syria.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A qualitative analysis of pharmacists' attitudes and practices regarding the sale of antibiotics without prescription in Syria

Bahnassi

2015

Journal of Taibah University Medical Sciences

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“…In a cross-sectional client simulation study in Syria, 87% of the pharmacies sold antibiotics without a prescription. This proportion increased up to 97% when the client simulators insisted on buying antibiotics [19]. Similar studies in Saudi Arabia and India had comparable results: 78% and 94% of visited pharmacies dispensed over the counter antibiotics [20,21].…”

Section: Discussionmentioning

confidence: 92%

Antibiotic sales in rural and urban pharmacies in northern Vietnam: an observational study

Nga

Chúc

Hoa

et al. 2014

BMC Pharmacol Toxicol

190

168

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BackgroundThe irrational overuse of antibiotics should be minimized as it drives the development of antibiotic resistance, but changing these practices is challenging. A better understanding is needed of practices and economic incentives for antibiotic dispensing in order to design effective interventions to reduce inappropriate antibiotic use. Here we report on both quantitative and qualitative aspects of antibiotic sales in private pharmacies in northern Vietnam.MethodA cross-sectional study was conducted in which all drug sales were observed and recorded for three consecutive days at thirty private pharmacies, 15 urban and 15 rural, in the Hanoi region in 2010. The proportion of antibiotics to total drug sales was assessed and the revenue was calculated for rural and urban settings. Pharmacists and drug sellers were interviewed by a semi-structured questionnaire and in-depth interviews to understand the incentive structure of antibiotic dispensing.ResultsIn total 2953 drug sale transactions (2083 urban and 870 rural) were observed. Antibiotics contributed 24% and 18% to the total revenue of pharmacies in urban and rural, respectively. Most antibiotics were sold without a prescription: 88% in urban and 91% in rural pharmacies. The most frequent reported reason for buying antibiotics was cough in the urban setting (32%) and fever in the rural area (22%). Consumers commonly requested antibiotics without having a prescription: 50% in urban and 28% in rural area. The qualitative data revealed that drug sellers and customer’s knowledge of antibiotics and antibiotic resistance were low, particularly in rural area.ConclusionOver the counter sales of antibiotic without a prescription remains a major problem in Vietnam. Suggested areas of improvement are enforcement of regulations and pricing policies and educational programs to increase the knowledge of drug sellers as well as to increase community awareness to reduce demand-side pressure for drug sellers to dispense antibiotics inappropriately.

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“…Indeed, before the Syrian war, prevalence of ESBL urinary tract infections associated with wide use of antimicrobial drugs was high ( 6 ). In addition, sale of antimicrobial drugs without prescriptions was common in Damascus and other areas ( 7 ). The war added inadequate sanitation, hospital and infrastructure destruction, and suboptimal infection control measures.…”

mentioning

confidence: 99%