The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Antibiotic sales in rural and urban pharmacies in northern Vietnam: an observational study
Open accessAbstract
BACKGROUND: The irrational overuse of antibiotics should be minimized as it drives the development of antibiotic resistance, but changing these practices is challenging. A better understanding is needed of practices and economic incentives for antibiotic dispensing in order to design effective interventions to reduce inappropriate antibiotic use. Here we report on both quantitative and qualitative aspects of antibiotic sales in private pharmacies in northern Vietnam. METHOD: A cross-sectional study was conducted in which all drug sales were observed and recorded for three consecutive days at thirty private pharmacies, 15 urban and 15 rural, in the Hanoi region in 2010. The proportion of antibiotics to total drug sales was assessed and the revenue was calculated for rural and urban settings. Pharmacists and drug sellers were interviewed by a semi-structured questionnaire and in-depth interviews to understand the incentive structure of antibiotic dispensing. RESULTS: In total 2953 drug sale transactions (2083 urban and 870 rural) were observed. Antibiotics contributed 24% and 18% to the total revenue of pharmacies in urban and rural, respectively. Most antibiotics were sold without a prescription: 88% in urban and 91% in rural pharmacies. The most frequent reported reason for buying antibiotics was cough in the urban setting (32%) and fever in the rural area (22%). Consumers commonly requested antibiotics without having a prescription: 50% in urban and 28% in rural area. The qualitative data revealed that drug sellers and customer's knowledge of antibiotics and antibiotic resistance were low, particularly in rural area. CONCLUSION: Over the counter sales of antibiotic without a prescription remains a major problem in Vietnam. Suggested areas of improvement are enforcement of regulations and pricing policies and educational programs to increase the knowledge of drug sellers as well as to increase community awareness to reduce demand-side pressure for drug sellers to dispense antibiotics inappropriately.
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“This observation parallels findings by Nga et al in Vietnam, which noted that pharmacies in residential areas were more likely to dispense antibiotics without a prescription than those in rural settings. 19”
From Evaluation of antibiotic dispensing without prescription by community pharmacies: a simulated patient study (2025) · cites this paper as [19]
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“Such inconsistency in dispensing practice will, in the long run, cost those CDROs that are adhering to the ethical and regulatory standards by losing trust of customers and eventually hurting their business [24, 40, 42, 46–49].”
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 [48]
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“In such environments where customer satisfaction or need is of a central value, most CDRO staff opt to respond to customer’s request and need without properly scrutinising the consequences or repercussion of their actions [24, 39, 40, 42–44, 46–48].”
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 [48]
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“if they experience poor satisfaction with the services of health facilities in nearby areas (e.g. prolonged waiting time due to the overcrowded services, doctors unable/unwilling to have enough consultation time with patients and less quality service) [40–42, 47–49]”
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 [48]
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“Nearly all (n = 10) [24, 39–43, 45, 46, 48, 49] met seven or more of the 10 JBI appraisal checklist criteria for qualitative studies.”
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“if they feel like their condition is not severe enough to visit a doctor [48]”
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“In addition, CDRO staff reported lack of knowledge regarding the regulatory frameworks governing antibiotic dispensing and/or being misinformed about these policies (e.g. assuming some types of antibiotics are permitted to be sold as OTC medicines) [48].”
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“This tells us that drivers may not be similar between urban and rural CDROs [48, 75].”
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Citations
Cites
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“The main themes and connections were used to identify important causes of inappropriate antibiotic dispensing in urban and rural pharmacies [17].”
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“Similar studies in Saudi Arabia and India had comparable results: 78% and 94% of visited pharmacies dispensed over the counter antibiotics [20,21].”
ResultDrug utilisation and self-medication in rural communities in Vietnam
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“; licensee BioMed Central Ltd Commons Attribution License (http://creativec reproduction in any medium, provided the or community setting, where antibiotics are readily dispensed for self-limiting upper respiratory tract infections without a prescription [4-8].”
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Chúc, N. T. K., & Diwan, V. K. (2003) · Scandinavian Journal of Public Health · doi:10.1080/14034950310015031 · Cited by 118 · cited 1×
“The two study sites are: Bavi (site name: FilaBavi [14]) and Dong Da (site name: Dodalab [15]).”
BackgroundAntibiotic use following a Korean national policy to prohibit medication dispensing by physicians
Park, S., Soumerai, S. B., Adams, A. S., Finkelstein, J. A., Jang, S., & Ross-Degnan, D. (2005) · Health Policy and Planning · doi:10.1093/heapol/czi033 · Cited by 107 · cited 1×
“Similarly, inappropriate antibiotic prescribing in viral illness remarkable declined as in Korea by prohibiting prescribers from dispensing medications themselves [25].”
Background
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Cited by
Sorted by citations
Antibiotic stewardship in low- and middle-income countries: the same but different?
Cox, J. A., Vlieghe, E., Mendelson, M., Wertheim, H., Ndegwa, L., Villegas, M. V., Gould, I., & Levy Hara, G. (2017) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2017.07.010 · Cited by 529
“155 Perverse financial incentives for prescribers and drug providers, legal concerns and patient demands are 156 additional drivers of antibiotic overuse(19, 34-36).”
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Self-citationA current perspective on antimicrobial resistance in Southeast Asia
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Self-citationPerformance of retail pharmacies in low- and middle-income Asian settings: a systematic review
Miller, R., & Goodman, C. (2016) · Health Policy and Planning · doi:10.1093/heapol/czw007 · Cited by 225
“These include honouring improper prescriptions, such as those that are out of date, and selling POMs without a prescription (Dua et al. 1994; Larsson et al. 2006; Kotwani et al. 2012; Nga et al. 2014).”
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Metadata
- Authors
- Nga, D. T. T., Chuc, N. T. K., Hoa, N. P., Hoa, N. Q., Nguyen, N. T. T., Loan, H. T., Toan, T. K., Phuc, H. D., Horby, P., Van Yen, N., Van Kinh, N., & Wertheim, H. F.
- Affiliations
- Oxford University Clinical Research Unit (VN)
- Hanoi Medical University (VN)
- Institute of Mathematics (VN)
- University of Oxford (GB)
- Corresponding author
- Nga, Do Thi Thuy
- Nguyen, Nguyen Thi Thuy
- Venue
- BMC Pharmacology and Toxicology
- Published
- 2014-02-20
- Volume
- 15
- Issue
- 1
- Pages
- 6-6
- ISSN
- 2050-6511 (ISSN-L)
- PMC
- PMC3946644
- OpenAlex
- W2164556138
- Cited by
- 228
- References
- 23
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 17 · 2023: 18 · 2022: 28 · 2021: 31 · 2020: 17 · 2019: 26 · 2018: 25 · 2017: 16 · 2016: 15 · 2015: 9 · 2014: 3
- FWCI
- 11.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Pharmacology and Toxicology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Greater South Information System
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
- Health Sciences › Nursing › Issues, ethics and legal aspects › Pharmaceutical industry and healthcare
- Keywords
- antibiotic sales, prescription drug sales, inappropriate antibiotic use, antibiotic resistance, private pharmacies, urban-rural differences, Hanoi, Vietnam
- MeSH terms
- Anti-Bacterial Agents, Commerce, Nonprescription Drugs, Health Knowledge, Attitudes, Practice, Pharmacies, Surveys and Questionnaires, Rural Population, Urban Population, Vietnam, Drug Resistance, Bacterial
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