Analysing policy interventions to prohibit over‐the‐counter antibiotic sales in four Latin American countries
Open accessAbstract
Objectives: To describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico (1995–2009) to prohibit antibiotic OTC sales and explore limitations in available data. Methods: We searched and analysed legislation, grey literature and peer‐reviewed publications on regulatory interventions and implementation strategies to enforce prohibition of OTC antibiotic sales. We also assessed the impact using private sector retail sales data of antibiotics studying changes in level and consumption trends before and after the policy change using segmented time series analysis. Finally, we assessed the completeness and data quality through an established checklist to test the suitability of the data for analysis of the interventions. Results: Whereas Chile implemented a comprehensive package of interventions to accompany regulation changes, Colombia's reform was limited to the capital district and Venezuela's limited to only some antibiotics and without awareness campaigns. In Mexico, no enforcement was enacted. The data showed a differential effect of the intervention among the countries studied with a significant change in level of consumption in Chile (−5.56 DID ) and in Colombia (−1.00 DID ). In Venezuela and Mexico, no significant change in level and slope was found. Changes in population coverage were identified as principal limitations of using sales data for evaluating the reform impact. Conclusion: Retail sales data can be useful when assessing policy impact but should be supplemented by other data sources such as public sector sales and prescription data. Implementing regulatory enforcement has shown some impact, but a sustainable, concerted approach will be needed to address OTC sales in the future.
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Studies in Zimbabwe, Chile, Colombia, Brazil, Mexico, Korea and Saudi Arabia found strict enforcement of existing laws to be effective in containing non-prescribed antibiotic provision.
“A number of studies conducted in Zimbabwe, Chile, Colombia, Brazil, Mexico and Korea in addition to a study completed in Saudi Arabia found strict enforcement of existing laws to be effective in containing the non-prescribed antibiotics provision [61–65].”
From No prescription? No problem: drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries: a systematic review of qualitative studies (2021) · cites this paper as [64]
The Abstract and ‘Antibiotic sales before and after the policy interventions’ report reduced antibiotic consumption after enforcement in Chile and a smaller reduction in Colombia. But the Discussion says the study cannot establish whether Chile’s intervention stopped non-prescription sales, and reports low compliance in Colombia. ‘Policy measures introduced’ says Mexico did not enforce its regulations during the study period; this paper does not study Zimbabwe, Brazil, Korea or Saudi Arabia (page numbers unavailable). (LLM, conf=0.88)
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- Authors
- Wirtz, V. J., Herrera‐Patino, J. J., Santa‐Ana‐Tellez, Y., Dreser, A., Elseviers, M., & Vander Stichele, R. H.
- Affiliations
- Instituto Nacional de Salud Pública (MX)
- Center for Health Systems Research National Institute of Public Health Mexico
- University of Antwerp (BE)
- Center of Clinical Pharmacology Heymans Institute of Pharmacology Faculty of Medicine and Health Sciences Ghent University Belgium
- Venue
- Tropical Medicine & International Health
- Publisher
- Wiley
- Published
- 2013-03-29
- Volume
- 18
- Issue
- 6
- Pages
- 665-673
- ISSN
- 1360-2276 (ISSN-L)
- 1365-3156
- OpenAlex
- W1990688209
- Cited by
- 76
- References
- 13
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 11 · 2022: 8 · 2021: 18 · 2020: 8 · 2019: 7 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 3 · 2013: 1
- FWCI
- 3.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Tropical Medicine & International Health (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmaceutical industry and healthcare
- Keywords
- over-the-counter antibiotics, drug policy, regulatory enforcement, retail sales data, antibiotic consumption trends, policy impact assessment, data quality, Latin America, Chile, Colombia, Venezuela, Mexico
- MeSH terms
- Anti-Bacterial Agents, Chile, Colombia, Drug Utilization, Nonprescription Drugs, Health Policy, Humans, Legislation, Drug, Mexico, Pharmacies, Drug Prescriptions, Venezuela
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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