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Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study
Worldwide, antimicrobial resistance is increasing rapidly and is associated with misuse of antimicrobials. The HATUA study (a broader 3-country study) investigated the antibiotic dispensing practices of pharmaceutical providers to clients, particularly the propensity to dispense without prescription...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389015/ https://www.ncbi.nlm.nih.gov/pubmed/34439074 http://dx.doi.org/10.3390/antibiotics10081025 |
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author | Ndaki, Pendo M. Mushi, Martha F. Mwanga, Joseph R. Konje, Eveline T. Ntinginya, Nyanda E. Mmbaga, Blandina T. Keenan, Katherine Sabiiti, Wilber Kesby, Mike Benitez-Paez, Fernando Sandeman, Alison Holden, Matthew T. G. Mshana, Stephen E. |
author_facet | Ndaki, Pendo M. Mushi, Martha F. Mwanga, Joseph R. Konje, Eveline T. Ntinginya, Nyanda E. Mmbaga, Blandina T. Keenan, Katherine Sabiiti, Wilber Kesby, Mike Benitez-Paez, Fernando Sandeman, Alison Holden, Matthew T. G. Mshana, Stephen E. |
author_sort | Ndaki, Pendo M. |
collection | PubMed |
description | Worldwide, antimicrobial resistance is increasing rapidly and is associated with misuse of antimicrobials. The HATUA study (a broader 3-country study) investigated the antibiotic dispensing practices of pharmaceutical providers to clients, particularly the propensity to dispense without prescription. A cross-sectional study using a ‘mystery client’ method was conducted in 1148 community pharmacies and accredited drugs dispensing outlets (ADDO) in Mwanza (n = 612), Mbeya (n = 304) and Kilimanjaro (n = 232) in Tanzania. Mystery clients asked directly for amoxicillin, had no prescription to present, did not discuss symptoms unless asked [when asked reported UTI-like symptoms] and attempted to buy a half course. Dispensing of amoxicillin without prescription was common [88.2, 95%CI 86.3–89.9%], across all three regions. Furthermore, the majority of outlets sold a half course of amoxicillin without prescription: Mwanza (98%), Mbeya (99%) and Kilimanjaro (98%). Generally, most providers in all three regions dispensed amoxicillin on demand, without asking the client any questions, with significant variations among regions [p-value = 0.003]. In Mbeya and Kilimanjaro, providers in ADDOs were more likely to do this than those in pharmacies but no difference was observed in Mwanza. While the Tanzanian government has laws, regulations and guidelines that prohibit antibiotic dispensing without prescription, our study suggests non-compliance by drug providers. Enforcement, surveillance, and the provision of continuing education on dispensing practices is recommended, particularly for ADDO providers. |
format | Online Article Text |
id | pubmed-8389015 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83890152021-08-27 Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study Ndaki, Pendo M. Mushi, Martha F. Mwanga, Joseph R. Konje, Eveline T. Ntinginya, Nyanda E. Mmbaga, Blandina T. Keenan, Katherine Sabiiti, Wilber Kesby, Mike Benitez-Paez, Fernando Sandeman, Alison Holden, Matthew T. G. Mshana, Stephen E. Antibiotics (Basel) Article Worldwide, antimicrobial resistance is increasing rapidly and is associated with misuse of antimicrobials. The HATUA study (a broader 3-country study) investigated the antibiotic dispensing practices of pharmaceutical providers to clients, particularly the propensity to dispense without prescription. A cross-sectional study using a ‘mystery client’ method was conducted in 1148 community pharmacies and accredited drugs dispensing outlets (ADDO) in Mwanza (n = 612), Mbeya (n = 304) and Kilimanjaro (n = 232) in Tanzania. Mystery clients asked directly for amoxicillin, had no prescription to present, did not discuss symptoms unless asked [when asked reported UTI-like symptoms] and attempted to buy a half course. Dispensing of amoxicillin without prescription was common [88.2, 95%CI 86.3–89.9%], across all three regions. Furthermore, the majority of outlets sold a half course of amoxicillin without prescription: Mwanza (98%), Mbeya (99%) and Kilimanjaro (98%). Generally, most providers in all three regions dispensed amoxicillin on demand, without asking the client any questions, with significant variations among regions [p-value = 0.003]. In Mbeya and Kilimanjaro, providers in ADDOs were more likely to do this than those in pharmacies but no difference was observed in Mwanza. While the Tanzanian government has laws, regulations and guidelines that prohibit antibiotic dispensing without prescription, our study suggests non-compliance by drug providers. Enforcement, surveillance, and the provision of continuing education on dispensing practices is recommended, particularly for ADDO providers. MDPI 2021-08-23 /pmc/articles/PMC8389015/ /pubmed/34439074 http://dx.doi.org/10.3390/antibiotics10081025 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ndaki, Pendo M. Mushi, Martha F. Mwanga, Joseph R. Konje, Eveline T. Ntinginya, Nyanda E. Mmbaga, Blandina T. Keenan, Katherine Sabiiti, Wilber Kesby, Mike Benitez-Paez, Fernando Sandeman, Alison Holden, Matthew T. G. Mshana, Stephen E. Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study |
title | Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study |
title_full | Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study |
title_fullStr | Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study |
title_full_unstemmed | Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study |
title_short | Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study |
title_sort | dispensing antibiotics without prescription at community pharmacies and accredited drug dispensing outlets in tanzania: a cross-sectional study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389015/ https://www.ncbi.nlm.nih.gov/pubmed/34439074 http://dx.doi.org/10.3390/antibiotics10081025 |
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