Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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
_version_ 1783742767450554368
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
work_keys_str_mv AT ndakipendom dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT mushimarthaf dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT mwangajosephr dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT konjeevelinet dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT ntinginyanyandae dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT mmbagablandinat dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT keenankatherine dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT sabiitiwilber dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT kesbymike dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT benitezpaezfernando dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT sandemanalison dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT holdenmatthewtg dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT mshanastephene dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy
AT dispensingantibioticswithoutprescriptionatcommunitypharmaciesandaccrediteddrugdispensingoutletsintanzaniaacrosssectionalstudy