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Title: Antibiotic dispensation without a prescription worldwide: a systematic review
Author: Batista, Ana Daniela
Rodrigues, Daniela A.
Figueiras, Adolfo
Zapata-Cachafeiro, Maruxa
Roque, Fátima
Herdeiro, Maria Teresa
Keywords: Antibiotics
Non-prescription antibiotic dispensing
Pharmacy practice
Issue Date: Nov-2020
Publisher: MDPI
Abstract: Antibiotic resistance still remains a major global public health problem and the dispensing of antibiotics without a prescription at community pharmacies is an important driver of this. MEDLINE, Pubmed and EMBASE databases were used to search and identify studies reporting the dispensing of non-prescribed antibiotics in community pharmacies or drugstores that sell drugs for human use, by applying pharmacy interviews/questionnaires methods and/or simulated patient methods. Of the 4683 studies retrieved, 85 were included, of which 59 (69.4%) were published in low-and middle-income countries. Most of the papers (83.3%) presented a percentage of antibiotic dispensing without a prescription above 60.0%. Sixty-one studies evaluated the active substance and the most sold antibiotics without a prescription were amoxicillin (86.9%), azithromycin (39.3%), ciprofloxacin (39.3%), and amoxicillin-clavulanic acid (39.3%). Among the 65 articles referencing the diseases/symptoms, this practice was shown to be mostly associated with respiratory system problems (100.0%), diarrhea (40.0%), and Urinary Tract Infections (30.8%). In sum, antibiotics are frequently dispensed without a prescription in many countries and can thus have an important impact on the development of resistance at a global level. Our results indicate the high need to implement educational and/or regulatory/administrative strategies in most countries, aiming to reduce this practice.
Peer review: yes
DOI: 10.3390/antibiotics9110786
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DCM - Artigos

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