A comparative study between prescribed and over-the-counter antibiotics

OBJECTIVE: To examine the influence of pharmacists’ demographic characteristics on dispensing antibiotics purchased with and without a prescription in the community pharmacies.

METHODS: This cross-sectional study was conducted in 24 randomly-selected community pharmacies located in Abu Dhabi, United Arab Emirates between March and September 2009. Data were collected through a closed-structured questionnaire and analyzed using the Statistical Package for Social Sciences Version 17. Descriptive statistics, odds ratios, significance and 95% CI and logistic regression analyses were then used to analyze the resulting data.

RESULTS: Participating pharmacists conducted a total of 1645 antibiotic transactions (1211 [73.6%] dispensed with prescriptions versus and 434 [26.4%] without). Gender and socioeconomic status of the patients had a significant effect in acquiring antibiotics without prescription (p=0.012, p=0.001). Clarithromycin (91.5%), cefuroxime (91.3%), and co-amoxiclav (66.4%) were dispensed with prescription. Ceftriaxone (53.3%), amoxicillin (47.8%) and co-amoxiclav (33.6%) were dispensed without prescription. Dispensing of antibiotics with prescription were frequently given a 5, 7, or 10 day regimen, while those without prescription were frequently given 3-7 days duration. Co-amoxiclav for sore throat was commonly dispensed without prescription. Ceftriaxone for sexually transmitted diseases was dispensed at a similar rate, both with and without prescription.

CONCLUSION: Dispensing antibiotic without prescription is illegal and alarming. Patient interviews and interventions to improve the current prescribing pattern for both prescribers and pharmacists are highly warranted.