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Pattern of Antibiotic Dispensing at Pharmacies According to Access, Watch, Reserve (AWaRe) Classification: Multicenter Study After COVID-19 Waves in Different Districts of Pakistan

Overview
Journal BMC Res Notes
Publisher Biomed Central
Date 2025 Jan 28
PMID 39871298
Authors
Faiz Ullah Khan
Farman Ullah Khan
Aqsa Sajjad
Tawseef Ahmad
Tauqeer Hussain Mallhi
Sayyad Ali
Kamran Hidayat Ullah
Shahid Shah
Affiliations
Soon will be listed here.
Abstract

Objective: The dispensing of non-prescription antibiotics is a worldwide concern, and antibiotics should only be dispensed with a legitimate prescription.

Methodology: A cross-sectional study was conducted using the simulated client methodology, with data collected, recorded, and analyzed using SPSS.

Results: The simulated client visited 210 pharmacies, of which 70 dispensed antibiotics without a prescription. Outcomes The most often suggested antibiotics for upper respiratory tract infections (URTIs) were Amoxicillin (n = 17, 8.1%), Clarithromycin (n = 20, 9.5%), and Moxifloxacin (n = 13, 6.2%), with 33.3% of medications dispensed without a prescription for URTIs. Cefixime (n = 20, 9.5%) and ceftriaxone (n = 17, 8.1%) were the most often administered medications for urinary tract infections (UTIs). The non-prescribed dispensing of upper respiratory tract infections (URTIs) and urinary tract infections (UTIs) was markedly elevated (p < 0.05). Antibiotics were dispensed without a prescription for diarrheal diseases in over 50% of pharmacies, with Metronidazole (n = 23, 11%), Azithromycin (n = 16, 7.6%), and Rifaximin (n = 15, 7.1%) being the most often prescribed. In all bivariate and multivariate models, male gender was associated with reduced likelihood (COR: 0.30, 95% CI: 0.12-0.72; p = 0.0079 and AOR: 0.03, 95% CI: 0.005-0.15; p = 0.0001). Individuals aged 30 years and older exhibited increased odds of dispensing in both bivariate (COR: 3.67, 95% CI: 1.69-8.87; p = 0.0018) and multivariate analyses (AOR: 9.44, 95% CI: 2.55-61.70; p = 0.001). The presence of a pharmacist on duty markedly diminished the likelihood of administering antibiotics without a prescription (COR: 0.13, 95% CI: 0.06-0.25; p = < 0.001; AOR: 0.06, 95% CI: 0.03-0.16; p = < 0.001).

Conclusion: These findings highlight the imperative of enforcing existing laws and implementing rigorous rules, alongside pharmacy-centered antimicrobial stewardship programs that focus on accurate dispensing practices to mitigate antimicrobial resistance.

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