Sale of antibiotics without a prescription at community pharmacies in urban China: a multicentre cross-sectional survey
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Objectives: To quantify sales of antibiotics without a medical prescription and to assess the quality of pharmacy services in relation to the antibiotics sold in community pharmacies in urban China. Methods: A multicentre cross-sectional survey of community pharmacies was undertaken in 2015 using the simulated client method. Two clinical case scenarios (paediatric diarrhoea and adult acute upper respiratory infection) were presented at systematically sampled community pharmacies in Eastern (Nanjing), Central (Changsha) and Western China (Xi'an). Results: Of 256 pharmacies, antibiotics were obtained without a prescription from 55.9% (95% CI: 49.5%-62.0%) when paediatric diarrhoea was simulated and from 77.7% (95% CI: 72.1%-82.7%) when adult respiratory infection was simulated. Of the pharmacies where antibiotics were dispensed, 83.9% and 66.3% dispensed after the simulated clients requested or insisted in the case of paediatric diarrhoea and adult respiratory infection, respectively. Significant differences ( P < 0.001, χ 2 test) in inappropriate antibiotic dispensing were found among cities, with 57.7%, 37.3% and 73.7% in the case of paediatric diarrhoea and 60.8%, 80.7% and 96.1% in adult respiratory infection in Nanjing, Changsha and Xi'an, respectively. Pharmacists were available in only 14.8% (95% CI: 10.7%-19.8%) of the pharmacies. The performance of pharmacy staff regarding the provision of information and advice was unsatisfactory. Conclusions: Antibiotics were easily obtained without a prescription in community pharmacies in urban China. Measures to enhance the enforcement of prescription-only regulations and training programmes for pharmacy staff to promote the appropriate use of antibiotics are warranted.
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Studies have shown that 40-60% of inappropriate antibiotic use occurs in outpatient settings, such as community pharmacies, where antibiotics are dispensed without prescriptions.
“Studies have shown that 40-60% of inappropriate antibiotic use occurs in outpatient settings, such as community pharmacies, where antibiotics are dispensed without prescriptions. 3”
From Evaluation of antibiotic dispensing without prescription by community pharmacies: a simulated patient study (2025) · cites this paper as [3]
The Results sections on paediatric diarrhoea and adult acute upper respiratory infection report that 55.9% and 77.7% of surveyed urban Chinese pharmacies, respectively, dispensed antibiotics without a prescription. These are percentages of pharmacies in two simulated scenarios, not evidence that 40–60% of all inappropriate antibiotic use occurs in outpatient settings. Page numbers are unavailable in our copy. (LLM, conf=0.90)
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Velusamy, S., ShyamSundar, S. S., & Regi, V. J. (2025) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20251716
- Authors
- Chang, J., Ye, D., Lv, B., Jiang, M., Zhu, S., Yan, K., Tian, Y., & Fang, Y.
- Affiliations
- Xi'an Jiaotong University (CN)
- Chinese University of Hong Kong (HK)
- Corresponding author
- Fang, Yu
- Venue
- Journal of Antimicrobial Chemotherapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-01-06
- Volume
- 72
- Issue
- 4
- Pages
- dkw519
- ISSN
- 0305-7453 (ISSN-L)
- 1460-2091
- OpenAlex
- W2571323599
- Cited by
- 128
- References
- 26
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 7 · 2023: 9 · 2022: 15 · 2021: 16 · 2020: 29 · 2019: 19 · 2018: 19 · 2017: 3
- FWCI
- 9.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Antimicrobial Chemotherapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- China Postdoctoral Science Foundation (2016T90935, 2015M580862)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmaceutical industry and healthcare
- Keywords
- community pharmacy, pharmacist recommendations, paediatric diarrhoea, acute upper respiratory tract infection, antibiotic stewardship, urban China
- MeSH terms
- Adult, Anti-Bacterial Agents, China, Commerce, Computer Simulation, Cross-Sectional Studies, Diarrhea, Humans, Pharmacies, Drug Prescriptions, Surveys and Questionnaires, Respiratory Tract Infections
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