SURVEY ON HOW ANTIBIOTICS ARE DISPENSED IN COMMUNITY PHARMACIES IN ALBANIA
Keywords:Drug Utilization, Antibiotics, Pharmacies, Professional Practice, Patient Simulation, Albania
Objective: To evaluate pharmacists' tendency to dispense antibiotics without prescription.
Methods: A random survey was conducted for this study. Statistical analyses were made with Open Epi. Research group personnel were instructed to ask the question "I need to get a package of amoxicillin", when posing as simulated patients in pharmacies. The main outcome of the study was considered percentages of approval of this request.
Results: Out of 450 pharmacies visited in this survey. In 259 pharmacies tested the request for dispensing antibiotic without production was approved (80% of tested pharmacies, Confidence Levels 75.57%-84.26%). Generally some questions (like age or possible allergies) were asked from pharmacists before approving the request of dispensing the antibiotic without prescription. The results of the survey suggest that dispensing of antibiotics without prescription is very common in Albania. The research group personnel were generally asked for further information before approving the request.
Conclusion: Different actions should be taken in the country to enhance compliance with regulation and protocols regarding dispensing antibiotics. These actions can be focused on regulatory enforcement and also in enhancement of awareness on antibiotic misuse and microbial resistance through public campaigns or targeted messages to professionals.
Goossens H, Ferech M, Vander Stichele R, Elseviers M, ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet 2005;365(9459):579-87.
Bronzwaer SL, Cars O, Buchholz U, MÃ¶lstad S, Goettsch W, Veldhuijzen IK, Kool JL, et al. European antimicrobial resistance surveillance system. a european study on the relationship between antimicrobial use and antimicrobial resistance. Emerging Infect Dis 2002;8(3):278-82.
Livermore M. The zeitgeist of resistance. J Antimicrob Chemother 2007;60(Suppl 1):i59-61.
McNeill V, Cruickshank M, Duguid M. Safer use of antimicrobials in hospitals: the value of antimicrobial usage data. Med J Aust 2010;193(8);S114-S117.
WHO drug utilization guideline. Guidelines for ATC classification and DDD assignment 2014. Available from: http:// www.whocc.no/filearchive/publications/2014_guidelines.pdf.
Standard 3: Preventing and controlling healthcare associated infectionsâ€“antimicrobial stewardship criterion. Available from: http://www.safetyandquality.gov.au/our-work/healthcare-associated-infection/antimicrobial-stewardship/.
Emily Leung, Diana E Weil, Mario Raviglione, Hiroki Nakatan. The world health organization world health day antimicrobial resistance technical working group. the who policy package to combat antimicrobial resistance. Bull WHO 2011;89:390-2.
Kotwani A, Wattal C, Joshi PC, Holloway K. Irrational use of antibiotics and role of the pharmacist: an insight from a qualitative study in New Delhi, India. Int J Clin Pharmacol Ther 2012;37(3):308-12.
Wickens HJ, Farrell S, Ashiru-Oredope DA, Jacklin A, Holmes A. The increasing role of pharmacists in antimicrobial stewardship in English hospitals. J Antimicrob Chemother 2013;68(11):2675-81.
Gastelurrutia MA, LarraÃ±aga B, Garay A, Echeveste Fde A, Fernandez-Llimos F. Impact of a program to reduce the dispensing of antibiotics without a prescription in Spain. J Pharm Pract 2013;11(4):185-90.
Watson MC, Norris P, Granas AG. A systematic review of the use of simulated patients and pharmacy practice research. Int J Pharm Prac 2006;14(2):89-93.
McManus P, Hammond ML, Whicker SD, Primrose JG, Mant A, Fairall SR. Antibiotic use in the Australian community, 1990-1995. Med J Aust 1997;167(3):124-7.
VÃ¤Ã¤nÃ¤nen MH, PietilÃ¤ K, Airaksinen M. Self-medication with antibiotics-does it really happen in Europe? Health Policy 2006;77(2):166-71.
Top Channel Tv Media. Available From: http://top-channel.tv/lajme/artikull.php?id=246238
Grigoryan L, Burgerhof JG, Degener JE, Deschepper R, Lundborg CS, Monnet DL, et al. SAR consortium. Attitudes, beliefs and knowledge concerning antibiotic use and self-medication: a comparative European study. Pharmacoepidemiol Drug Saf 2007;16(11):1234-43.
Roque F, Soares S, Breitenfeld L, LÃ³pez-DurÃ¡n A, Figueiras A, Herdeiro MT. Attitudes of community pharmacists to antibiotic dispensing and microbial resistance: a qualitative study in Portugal. Int J Clin Pharm 2013;35(3):417-24.
Law no. 105/2014. For drug and pharmaceutical service in the Republic of Albania. Available From: http:// www. parlament.al/web/pub/ligj_nr_105_dt_31_7_2014_18582_1. pdf
Shankar PR, Partha P, Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: a questionnaire-based study. Biomed Center Family Prac 2002;3:17.
Zaidi Sh, Nishtar NA. Rational prescription & use: a snapshot of the evidence from Pakistan and emerging concerns. Int J Pharm Pharm Sci 2013;5(1):131-5.