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2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic

BACKGROUND: Antimicrobial resistance (AMR) is a rising global health challenge. Antimicrobial use (AU) is a key factor in the development of AMR, but knowledge gaps remain on AU and dispensation in low- and middle-income countries (LMICs). AU can be purchased without prescriptions in many LMICs and...

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Autores principales: Mena Lora, Alfredo J, Almonte, Marcos, Jimenez, Mariel, Rodriguez Abreu, Julia, Rojas Fermin, Rita, Bleasdale, Susan C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809233/
http://dx.doi.org/10.1093/ofid/ofz360.1708
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author Mena Lora, Alfredo J
Almonte, Marcos
Jimenez, Mariel
Rodriguez Abreu, Julia
Rojas Fermin, Rita
Bleasdale, Susan C
author_facet Mena Lora, Alfredo J
Almonte, Marcos
Jimenez, Mariel
Rodriguez Abreu, Julia
Rojas Fermin, Rita
Bleasdale, Susan C
author_sort Mena Lora, Alfredo J
collection PubMed
description BACKGROUND: Antimicrobial resistance (AMR) is a rising global health challenge. Antimicrobial use (AU) is a key factor in the development of AMR, but knowledge gaps remain on AU and dispensation in low- and middle-income countries (LMICs). AU can be purchased without prescriptions in many LMICs and are available in pharmacies and non-pharmacy stores. We seek to describe the availability, training and AU recommendations in pharmacies and non-pharmacy stores in the Dominican Republic (DR). METHODS: We conducted a survey of pharmacies and non-pharmacy stores that dispense antimicrobials from March to April 2019 in randomly selected locations throughout metropolitan Santo Domingo. Data on the availability of antimicrobials and training on AU was obtained. Antimicrobial of choice for common symptoms such as dysuria, throat pain, diarrhea, fever, and cough were queried, and data tabulated. Availability of antimicrobials by phone and online delivery was assessed. RESULTS: A total of 35 stores were surveyed. Ten pharmacies and 15 nonpharmacy stores agreed to participate. Ten refused and were excluded. Fifty AU recommendations were given in pharmacies and 16 in non-pharmacy stores. The most common type of antimicrobial recommended were aminopenicillins (Figure 1). Staff received prior training on antimicrobials in 70% of pharmacies and 0% of non-pharmacy stores. Antimicrobial recommendations by symptom in pharmacies and non-pharmacy stores are seen in Figure 2 and 3. Antimicrobials are available for phone delivery in 100% of pharmacies and 90% of non-pharmacy stores. No antimicrobials were available via online delivery apps. CONCLUSION: Antimicrobials are widely available in the DR without prescriptions and can be purchased in person or via phone delivery. Aminopenicillins are commonly prescribed and may contribute to high rates of ESBL in the DR. Pharmacy staff gave more specific symptom-based recommendations than non-pharmacy staff and commonly had prior training on antibiotic use. In LMICs with easy access to antimicrobials, frontline staff in pharmacies and non-pharmacy stores are gatekeepers for AU and may benefit from further education and training. Further studies on attitudes and perceptions related to antimicrobial use in the community are needed. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68092332019-10-28 2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic Mena Lora, Alfredo J Almonte, Marcos Jimenez, Mariel Rodriguez Abreu, Julia Rojas Fermin, Rita Bleasdale, Susan C Open Forum Infect Dis Abstracts BACKGROUND: Antimicrobial resistance (AMR) is a rising global health challenge. Antimicrobial use (AU) is a key factor in the development of AMR, but knowledge gaps remain on AU and dispensation in low- and middle-income countries (LMICs). AU can be purchased without prescriptions in many LMICs and are available in pharmacies and non-pharmacy stores. We seek to describe the availability, training and AU recommendations in pharmacies and non-pharmacy stores in the Dominican Republic (DR). METHODS: We conducted a survey of pharmacies and non-pharmacy stores that dispense antimicrobials from March to April 2019 in randomly selected locations throughout metropolitan Santo Domingo. Data on the availability of antimicrobials and training on AU was obtained. Antimicrobial of choice for common symptoms such as dysuria, throat pain, diarrhea, fever, and cough were queried, and data tabulated. Availability of antimicrobials by phone and online delivery was assessed. RESULTS: A total of 35 stores were surveyed. Ten pharmacies and 15 nonpharmacy stores agreed to participate. Ten refused and were excluded. Fifty AU recommendations were given in pharmacies and 16 in non-pharmacy stores. The most common type of antimicrobial recommended were aminopenicillins (Figure 1). Staff received prior training on antimicrobials in 70% of pharmacies and 0% of non-pharmacy stores. Antimicrobial recommendations by symptom in pharmacies and non-pharmacy stores are seen in Figure 2 and 3. Antimicrobials are available for phone delivery in 100% of pharmacies and 90% of non-pharmacy stores. No antimicrobials were available via online delivery apps. CONCLUSION: Antimicrobials are widely available in the DR without prescriptions and can be purchased in person or via phone delivery. Aminopenicillins are commonly prescribed and may contribute to high rates of ESBL in the DR. Pharmacy staff gave more specific symptom-based recommendations than non-pharmacy staff and commonly had prior training on antibiotic use. In LMICs with easy access to antimicrobials, frontline staff in pharmacies and non-pharmacy stores are gatekeepers for AU and may benefit from further education and training. Further studies on attitudes and perceptions related to antimicrobial use in the community are needed. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809233/ http://dx.doi.org/10.1093/ofid/ofz360.1708 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Mena Lora, Alfredo J
Almonte, Marcos
Jimenez, Mariel
Rodriguez Abreu, Julia
Rojas Fermin, Rita
Bleasdale, Susan C
2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic
title 2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic
title_full 2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic
title_fullStr 2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic
title_full_unstemmed 2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic
title_short 2028. A Survey of Antimicrobial Availability, Training, and Antimicrobial Recommendations by Staff in Pharmacies and Non-pharmacy Stores in the Dominican Republic
title_sort 2028. a survey of antimicrobial availability, training, and antimicrobial recommendations by staff in pharmacies and non-pharmacy stores in the dominican republic
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809233/
http://dx.doi.org/10.1093/ofid/ofz360.1708
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