Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: a cross sectional study

Antibiotics sales without medical prescriptions are increasingly recognized as sources of antimicrobial misuse that can exacerbate the global burden of antibiotic resistance. We aimed to determine the percentage of pharmacies who sell antibiotics without medical prescriptions, examining the potentia...

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Bibliographic Details
Published in:	BMC public health Vol. 11; no. 1; p. 538
Main Authors:	Bin Abdulhak, Aref A, Altannir, Mohamad A, Almansor, Mohammed A, Almohaya, Mohammed S, Onazi, Atallah S, Marei, Mohammed A, Aldossary, Oweida F, Obeidat, Sadek A, Obeidat, Mustafa A, Riaz, Muhammad S, Tleyjeh, Imad M
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 07-07-2011 BioMed Central BMC
Subjects:	Anti-Bacterial Agents - therapeutic use Antibiotics Complications and side effects Cross-Sectional Studies Dosage and administration Drug Utilization - statistics & numerical data Female Humans Male Market share Methods Observational studies Pharmacies - statistics & numerical data Prescriptions - statistics & numerical data Saudi Arabia Saudi Arabia
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Summary:	Antibiotics sales without medical prescriptions are increasingly recognized as sources of antimicrobial misuse that can exacerbate the global burden of antibiotic resistance. We aimed to determine the percentage of pharmacies who sell antibiotics without medical prescriptions, examining the potential associated risks of such practice in Riyadh, Saudi Arabia, by simulation of different clinical scenarios. A cross sectional study of a quasi-random sample of pharmacies stratified by the five regions of Riyadh. Each pharmacy was visited once by two investigators who simulated having a relative with a specific clinical illness (sore throat, acute bronchitis, otitis media, acute sinusitis, diarrhea, and urinary tract infection (UTI) in childbearing aged women). A total of 327 pharmacies were visited. Antibiotics were dispensed without a medical prescription in 244 (77.6%) of 327, of which 231 (95%) were dispensed without a patient request. Simulated cases of sore throat and diarrhea resulted in an antibiotic being dispensed in (90%) of encounters, followed by UTI (75%), acute bronchitis (73%), otitis media (51%) and acute sinusitis (40%). Metronidazole (89%) and ciprofloxacin (86%) were commonly given for diarrhea and UTI, respectively, whereas amoxicillin/clavulanate was dispensed (51%) for the other simulated cases. None of the pharmacists asked about antibiotic allergy history or provided information about drug interactions. Only 23% asked about pregnancy status when dispensing antibiotics for UTI-simulated cases. We observed that an antibiotic could be obtained in Riyadh without a medical prescription or an evidence-based indication with associated potential clinical risks. Strict enforcement and adherence to existing regulations are warranted.
ISSN:	1471-2458 1471-2458
DOI:	10.1186/1471-2458-11-538