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
Open accessAbstract
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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“At the systemic level, inadequate healthcare infrastructure and weak regulatory enforcement contribute to antibiotic misuse in SSA (Sono et al),42 with many individuals purchasing antibiotics informally.”
From Public-targeted interventions addressing antimicrobial resistance and antibiotic use in Sub-Saharan Africa: a scoping review (2025) · cites this paper as [42]
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Metadata
- 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
- Yeika, Eugene
- Cook, Aislinn
- Kalungia, Aubrey
- 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
- 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
- Moore, Catrin E.
- Godman, Brian
- Meyer, Johanna C.
- 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
- 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
- green
- figshare.com
- 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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