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Cited by 95Antibiotic Use and ResistancePharmacy and Medical PracticesAntibiotic Resistance in Bacteria

The DOI matches its Crossref record; 223 of the 223 references it cites were found in a registry or an index.

Current rates of purchasing of antibiotics without a prescription across sub-Saharan Africa; rationale and potential programmes to reduce inappropriate dispensing and resistance

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Sono, Tiyani Milta, Yeika, Eugene, Cook, Aislinn, Kalungia, Aubrey, Opanga, Sylvia A., Acolatse, Joseph Elikem Efui, Sefah, Israel Abebrese, Jelić, Ana Golić, Campbell, Stephen, Lorenzetti, Giulia, Ul Mustafa, Zia, Marković-Peković, Vanda, Kurdi, Amanj, Anand Paramadhas, Bene D, Rwegerera, Godfrey Mutashambara, Amu, Adefolarin A, Alabi, Mobolaji Eniola, Wesangula, Evelyn, Oluka, Margaret, Khuluza, Felix, Chikowe, Ibrahim, Fadare, Joseph O., Ogunleye, Olayinka O., Kibuule, Dan, Hango, Ester, Schellack, Natalie, Ramdas, Nishana, Massele, Amos, Mudenda, Steward, Hoxha, Iris, Moore, Catrin E., Godman, Brian, Meyer, Johanna C.·2023·Expert Review of Anti-infective Therapy
DOI 10.1080/14787210.2023.2259106
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Abstract

INTRODUCTION: Antimicrobial resistance (AMR) is a global concern. Currently, the greatest mortality due to AMR is in Africa. A key driver continues to be high levels of dispensing of antibiotics without a prescription. AREAS COVERED: A need to document current rates of dispensing, their rationale and potential ways forward including antimicrobial stewardship programmes (ASPs). A narrative review was undertaken. The highest rates of antibiotic purchasing were in Eritrea (up to 89.2% of antibiotics dispensed), Ethiopia (up to 87.9%), Nigeria (up to 86.5%), Tanzania (up to 92.3%) and Zambia (up to 100% of pharmacies dispensing antibiotics without a prescription). However, considerable variation was seen with no dispensing in a minority of countries and situations. Key drivers of self-purchasing included high co-payment levels for physician consultations and antibiotic costs, travel costs, convenience of pharmacies, patient requests, limited knowledge of antibiotics and AMR and weak enforcement. ASPs have been introduced in some African countries along with quality targets to reduce inappropriate dispensing, centering on educating pharmacists and patients. EXPERT OPINION: ASP activities need accelerating among community pharmacies alongside quality targets, with greater monitoring of pharmacists' activities to reduce inappropriate dispensing. Such activities, alongside educating patients and healthcare professionals, should enhance appropriate dispensing of antibiotics and reduce AMR.

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Crossref · 10.1080/14787210.2023.2259106

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  1. O’Neill J TACKLING DRUG-RESISTANT INFECTIONS GLOBALLY: FINAL REPORT and RECOMMENDATIONS - THE REVIEW on ANTIMICROBIAL RESISTANCE. 2016. [cited 2023 Mar 20]. Available from: https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf
  2. OECD Health Policy Studies. Stemming the Superbug Tide. 2018. [cited 2023 Mar 21]. Available from: https://www.oecd-ilibrary.org/sites/9789264307599-en/index.html?itemId=/content/publication/9789264307599-en&mimeType=text/html

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Authors
Sono, T. M., Yeika, E., Cook, A., Kalungia, A., Opanga, S. A., Acolatse, J. E. E., Sefah, I. A., Jelić, A. G., Campbell, S., Lorenzetti, G., Ul Mustafa, Z., Marković-Peković, V., Kurdi, A., Anand Paramadhas, B. D., Rwegerera, G. M., Amu, A. A., Alabi, M. E., Wesangula, E., Oluka, M., Khuluza, F., Chikowe, I., Fadare, J. O., Ogunleye, O. O., Kibuule, D., Hango, E., Schellack, N., Ramdas, N., Massele, A., Mudenda, S., Hoxha, I., Moore, C. E., Godman, B., & Meyer, J. C.
Affiliations
  • Sefako Makgatho Health Sciences University (ZA)
  • Ministry of Public Health (CM)
  • St George's, University of London (GB)
  • University of Zambia (ZM)
  • University of Nairobi (KE)
  • Cape Coast Teaching Hospital (GH)
  • University of Health and Allied Sciences (GH)
  • Department of Pharmacy, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia & Herzegovina
  • Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, Malaysia
  • Hawler Medical University (IQ)
  • Department of Health Services Management, Central Medical Stores, Ministry of Health, Gaborone, Botswana
  • University of Botswana (BW)
  • Pharmacy Department, Eswatini Medical Christian University, Mbabane, Kingdom of Eswatini
  • University of KwaZulu-Natal (ZA)
  • East, Central and Southern Africa Health Community (TZ)
  • Kamuzu University of Health Sciences (MW)
  • Ekiti State University (NG)
  • Lagos State University (NG)
  • Busitema University (UG)
  • University of Namibia (NA)
  • University of Pretoria (ZA)
  • Hubert Kairuki Memorial University (TZ)
  • University of Medicine Tirana (AL)
  • University of Strathclyde (GB)
Corresponding author
Godman, Brian
ORCID
Venue
Expert Review of Anti-infective Therapy
Publisher
Informa UK Limited
Published
2023-10-03
Volume
21
Issue
10
Pages
1025-1055
ISSN
  • 1478-7210 (ISSN-L)
  • 1744-8336
DOI
10.1080/14787210.2023.2259106
OpenAlex
W4386979632
Cited by
95
References
223
Citations by year
2026: 20 · 2025: 44 · 2024: 24 · 2023: 7
FWCI
1.84
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Expert Review of Anti-infective Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • St George's Online Research Archive (St George's University of London) (acceptedVersion)
  • Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (acceptedVersion)
  • Figshare (submittedVersion, cc-by)
  • Research Explorer (The University of Manchester) (submittedVersion)
  • UpSpace Institutional Repository (University of Pretoria) (submittedVersion)
  • Figshare (cc-by)
Funders
Medical Research Council (MC_PC_16090)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
  • Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
Keywords
antibiotic self-medication, antimicrobial resistance, antimicrobial stewardship programs, community pharmacy, sub-Saharan Africa, pharmacy education, patient education, copayments, inappropriate antibiotic use
MeSH terms
Anti-Bacterial Agents, Ethiopia, Humans, Pharmacists, Drug Prescriptions

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