Global review finds antibiotics frequently supplied without prescription

24 July 2018

University researchers highlight worrying trend

About three in four antibiotic requests and three in five consultations in community pharmacies around the world result in the sale of antibiotics without a prescription, according to new research led by academics at the University of Central Lancashire (UCLan) and published in the Journal of Infection.

In a review of 38 studies, published from 2000 to 2017, on the frequency of the non-prescription sale and supply of antibiotics in community pharmacies in 24 countries, researchers found that 78 percent of antibiotic requests and 60 percent of consultations related to symptoms of infectious diseases resulted in the supply of antibiotics without a prescription.

Although all included countries, with the exception of one, classified antibiotics as prescription-only medicines, the overall pooled estimate of non-prescription supply of antibiotics was 62 percent, with non-prescription antibiotics being sold most frequently in community pharmacies in Indonesia (91 percent), Syria (87 percent), Saudi Arabia (85 percent), and Ethiopia (85 percent). Among regions, the supply of non-prescription antibiotics was highest in Latin America (78 percent).

"This irrational use of antibiotics could have a number of consequences, including the development and spread of resistance to antibiotics, as well as delayed hospital admissions and masking the diagnosis of infectious diseases."

Commenting on the findings, Dr Asa Auta, Lecturer in Pharmacy Practice at UCLan, said: “Non-prescription use of antibiotics is often associated with incomplete or shorter treatment courses and inappropriate drug and dose choices. This irrational use of antibiotics could have a number of consequences, including the development and spread of resistance to antibiotics, as well as delayed hospital admissions and masking the diagnosis of infectious diseases.

“While hospitals and other healthcare providers, particularly in more developed countries, are doing more to tackle this problem, there are very limited interventions into the supply of antibiotics in community pharmacies.”

The overuse and misuse of antibiotics can cause antimicrobial resistance – the resistance to drugs such as antivirals and antibiotics – which is a major global health concern.

Dr Auta added: “It’s clear that not enough is being done about this problem. Many countries now have laws restricting the sale of antibiotics without prescription. However, it is the enforcement of these laws that is lacking.”

Read the research report.