Utilization of antimicrobial agents with and without prescription by out-patients in selected pharmacies in South-eastern Nigeria
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We conducted a study in out-patient pharmacies in South-eastern Nigeria in order to determine the extent of self-medication of antimicrobial agents in this area, assess the dosing error associated with this practice and to ascertain the extent of involvement of community pharmacies.
A survey was carried out daily in selected community pharmacies for a period of 90 days. Data were collected on the number of patients visiting these shops for antimicrobial agents, the number getting their medication with a prescription, the number getting their order without prescription and on the type and dose of antimicrobial agents received.
Main out-come measure
The percentage of patients with prescription and without prescription was compared. The percentage under-dosages or over-dosages associated with how each antimicrobial agent was obtained were compared. The total DDDs of antimicrobial agents dispensed within this period with and without prescription were compared.
A total of 4,128 outpatients visited the shops for antimicrobial agents within the period and were involved in the study. Of this number, 1,742 (42.2%) came with a prescription from qualified medical personnel and 2,386 (57.8%) came without a prescription. A total of 13,693.13 DDDs of antimicrobial agents was dispensed, of which 56.38% was dispensed with prescription and 43.62% was dispensed without prescription. The degrees of under-dosing were significantly (P < 0.05) higher in regimen filled without prescription when compared to those filled with prescription.
Majority of the patients in this region still obtains their antimicrobial agents without a proper prescription, which is associated with sub-therapeutic dosing of these agents. There is a need for better regulation of antimicrobial agents dispensing and utilization in the region.
KeywordsAntimicrobial agents Antibiotics Antimicrobial agents resistance Dispensing Prescription Nigeria
We acknowledge the cooperation and contributions of some members of The Association of Community Pharmacy Practice of Nigeria (ACPN).
This research was funded through personal contributions of the authors only.
- 1.Rang HP, Dale MM, Ritter JM. Basic principles of chemotherapy. In Pharmacology, Churchill Livingstone: London, 1995. 681–695 ISBN 0 443 05086 4.Google Scholar
- 2.Levy SB, Burke JP, Wallace CK. Antibiotics use and antibiotic resistance worldwide. Rev Infect Dis 1987;3:745.Google Scholar
- 5.Goossens H, Ferech M, Stichele RV et al. Outpatient antibiotic use in Europe and association with resistance; a cross-national database study, 2005; 365:579–587. www.thelancet.com.Google Scholar
- 9.Kunin CM et al. Social, behavioral, and practical factors affecting antibiotic use worldwide: report of Task Force 4. Rev Infect Dis 1987;993:S270–S285.Google Scholar
- 12.British National Formulary. BMA and RPSGB: London, 2005; BNF-Vol 50, ISBN 0 85369 4621.Google Scholar
- 13.World Health Organisation. The anatomical therapeutical chemical classification system with defined daily doses (ATC/DDD). Norway: WHO, 2004. http://www.who.int/classsification/atcddd/ (accessed January 6, 2007) .
- 17.World Health Organisation. Global Strategy for Containment of Antimicrobial Resistance, 2001;WHO/CDS/CSR/DRS/2001.2.Google Scholar
- 18.World Health Organization. World Health Assembly (fifty-first). Emerging and other communicable diseases: antimicrobial resistance. 1998;WHA51.17.Google Scholar
- 22.t’Hoen E. Direct-to-consumer advertising: for better profits or for better health? Am J Health Syst Pharm 1998;55:594–7.Google Scholar
- 23.World Health Organization. Public education in rational drug use. Report of an informal consultation, Geneva, 23–26 November 1993.1994; WHO/DAP/94.1.Google Scholar
- 25.World Health Organization. Rational drug use: consumer education and information, Geneva, 1996; DAP/MAC/(8)96.6.Google Scholar