Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda
Open accessAbstract
Objectives: The main objective of this study was to assess practices of antibiotic prescription at registered drug shops with a focus on upper respiratory tract infections among children in order to provide data for policy discussions aimed at improving quality of care and patient safety in the private health sector in Uganda. Methods: A survey was conducted within 57 parishes from August to October 2014 in Mukono District, Uganda. Data was captured on the following variables: drug shop characteristics, training of staff in management of pneumonia, availability of guidelines and basic equipment, available antibiotics, knowledge on treatment of pneumonia in children aged <5 years. The main study outcome was the proportion of private health facilities prescribing an antibiotic. Results: A total of 170 registered drug shops were surveyed between August and October 2014. The majority of drug shops, 93.5% were prescribing antibiotics, especially amoxicillin and trimethoprim-sulfamethoxazole (septrin). The professional qualification of a provider was significantly associated with this practice, p=0.04; where lower cadre staff (nursing assistants and enrolled nurses) overprescribed antibiotics. A third, 29.4% of drug shop providers reported that antibiotics were the first-line treatment for children with diarrhoea; yet the standard guideline is to give oral rehydration salts and zinc tablets. Only few providers, 8.2%, had training on antibiotics, with 10.6% on pneumonia case management. Further to this, 7.1% drug shops had WHO-Integrated Management of Childhood Illness guidelines, and a negligible proportion (<1%) had respiratory timers and baby weighing scales. Although the majority of providers, 82.4%, knew severe signs and symptoms of pneumonia, few, 17.6%, knew that amoxicillin was the first-line drug for treatment of pneumonia in children according to the guidelines. Conclusions: There is urgent need to regulate drug shop practices of prescribing and selling antibiotics, for the safety of patients seeking care at these outlets.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Non-prescription sale of antibiotics is profoundly common practice in LMICs, as demonstrated by the high prevalence of the practice identified in simulated clients and questionnaire-based surveys.
“The non-prescription sale of antibiotics is profoundly common practice in LMICs as demonstrated by the high prevalence of the practice identified in simulated clients and questionnaire based surveys [16, 17, 22–33].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Newborn survival in Uganda: a decade of change and future implications
Mbonye, A. K., Sentongo, M., Mukasa, G., Byaruhanga, R., Sentumbwe-Mugisa, O., Waiswa, P., Sengendo, H. N., Aliganyira, P., Nakakeeto, M., Lawn, J. E., et al. (2012) · Health Policy and Planning · doi:10.1093/heapol/czs045 · Cited by 241 · see citing works
Self-citationDonkor, E. S., Tetteh-Quarcoo, P. B., Nartey, P., & Agyeman, I. O. (2012) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph9103519 · Cited by 225 · cited 1× · see citing works
“Similar findings have been documented in Ghana where a high proportion, 70% of the respondents, practiced self-medication, and the most common antibiotic used was amoxicillin.(23) It is noted that the majority of drug shops (53.”
ResultPatterns and Predictors of Self-Medication in Northern Uganda
Ocan, M., Bwanga, F., Bbosa, G. S., Bagenda, D. S., Waako, P. J., Ogwal-Okeng, J. W., & Obua, C. (2014) · PLoS ONE · doi:10.1371/journal.pone.0092323 · Cited by 173 · see citing works
Self-care and the informal sale of drugs in South Cameroon
van der Geest, S. (1987) · Social Science & Medicine · doi:10.1016/0277-9536(87)90232-2 · Cited by 170 · see citing works
Targeted imaging of bacterial infections: advances, hurdles and hopes
van Oosten, M., Hahn, M., Crane, L. M. A., Pleijhuis, R. G., Francis, K. P., van Dijl, J. M., & van Dam, G. M. (2015) · FEMS Microbiology Reviews · doi:10.1093/femsre/fuv029 · Cited by 146 · see citing works
The role of surveillance systems in confronting the global crisis of antibiotic-resistant bacteria
Pérez, F., & Villegas, M. V. (2015) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0000000000000182 · Cited by 89 · see citing works
Prevalence of Childhood Illnesses and Care-Seeking Practices in Rural Uganda
Mbonye, A. K. (2003) · The Scientific World JOURNAL · doi:10.1100/tsw.2003.52 · Cited by 58 · see citing works
Self-citationAn assessment of dispensing practices in private pharmacies in Dar-es-Salaam, Tanzania
Kagashe, G. A. B., Minzi, O., & Matowe, L. K. (2011) · International Journal of Pharmacy Practice · doi:10.1111/j.2042-7174.2010.00075.x · Cited by 53 · see citing works
The global challenge of new classes of antibacterial agents: an industry perspective
FERNANDES, P. B. (2015) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2015.06.003 · Cited by 44 · see citing works
Antimicrobial resistance: a priority for global health action
Chioro, A., Coll‐Seck, A. M., Høie, B., et al. (2015) · Bulletin of the World Health Organization · doi:10.2471/blt.15.158998 · Cited by 42 · see citing works
Minzi, O., & Manyilizu (2013) · Drug Healthcare and Patient Safety · doi:10.2147/dhps.s36409 · Cited by 38 · see citing works
Nsimba, S. E. D. (2007) · Tropical Doctor · doi:10.1258/004947507782333099 · Cited by 37 · see citing works
Antibiotic sale behaviour in Nairobi: a contributing factor to antimicrobial drug resistance.
Indalo, A. A. (1997) · PubMed · Cited by 36 · see citing works
Shelat, P. R. (2015) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2015/12724.5632 · Cited by 36 · see citing works
A comparison of prescribing practices between public and private sector physicians in Uganda.
Ogwal-Okeng, J. W., Obua, C., Waako, P. J., et al. (2004) · PubMed · Cited by 31 · see citing works
Community pharmaceutical care: an 8-month critical review of two pharmacies in Kampala.
Anyama, N., & Adome, R. O. (2003) · African Health Sciences · Cited by 24 · see citing works
Nouér, S. A., Nucci, M., & Anaissie, E. J. (2015) · Expert Review of Hematology · doi:10.1586/17474086.2015.1060576 · Cited by 23 · see citing works
Jacobs, B., WHITWORTH, J. A. G., Kambugu, F., et al. (2004) · Sexually Transmitted Diseases · doi:10.1097/01.olq.0000143087.08185.17 · Cited by 22 · see citing works
Anthony Κ Mbonye, Neema, S., & Magnussen, P. (2006) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh.2006.18.4.561 · Cited by 14 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Godman, B., Haque, M., McKimm, J., Abu Bakar, M., Sneddon, J., Wale, J., Campbell, S., Martin, A. P., Hoxha, I., Abilova, V., et al. (2020) · Current Medical Research and Opinion · doi:10.1080/03007995.2019.1700947 · Cited by 171 · see citing works
Alrasheedy, A. A., Alsalloum, M. A., Almuqbil, F. A., Almuzaini, M. A., Aba Alkhayl, B. S., Albishri, A. S., Alharbi, F. F., Alharbi, S. R., Alodhayb, A. K., Alfadl, A. A., et al. (2020) · Expert Review of Anti-infective Therapy · doi:10.1080/14787210.2020.1705156 · Cited by 102 · see citing works
Saleem, Z., Hassali, M. A., Hashmi, F. K., Godman, B., & Saleem, F. (2019) · Family Medicine and Community Health · doi:10.1136/fmch-2019-000138 · Cited by 77 · see citing works
Belachew, S. A., Hall, L., Erku, D. A., & Selvey, L. A. (2021) · BMC Public Health · doi:10.1186/s12889-021-11163-3 · Cited by 73 · see citing works
- Authors
- Mbonye, A. K., Buregyeya, E., Rutebemberwa, E., Clarke, S. E., Lal, S., Hansen, K. S., Magnussen, P., & LaRussa, P.
- Affiliations
- Ministry of Health (UG)
- Makerere University (UG)
- London School of Hygiene & Tropical Medicine (GB)
- University of Copenhagen (DK)
- Columbia University (US)
- Corresponding author
- Mbonye, Anthony K
- ORCID
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2016-03
- Volume
- 6
- Issue
- 3
- Pages
- e010632
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4800164
- OpenAlex
- W2297451877
- Cited by
- 75
- References
- 19
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 10 · 2023: 8 · 2022: 5 · 2021: 21 · 2020: 5 · 2019: 7 · 2018: 7 · 2017: 1 · 2016: 2
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- United States Agency for International Development
- National Institutes of Health
- Medical Research Council (MR/N003810/1)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- antibiotic prescribing, drug shops, private health sector, upper respiratory tract infection, pediatric pneumonia, patient safety, quality of care, amoxicillin, trimethoprim-sulfamethoxazole, provider training, guideline adherence, diarrhea treatment
- MeSH terms
- Amoxicillin, Anti-Bacterial Agents, Child, Child, Preschool, Cross-Sectional Studies, Diarrhea, Female, Humans, Infant, Health Knowledge, Attitudes, Practice, Male, Pharmacies, Pneumonia, Drug Prescriptions, Quality of Health Care, Surveys and Questionnaires, Uganda, Private Sector, Practice Guidelines as Topic, Case Management, Patient Safety
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 ›
Are you an author, or do you see a problem with this page? Request a review
