Cited by 124Antibiotic Use and ResistancePharmacy and Medical PracticesPharmaceutical and Antibiotic Environmental Impacts

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Prescription and non-prescription antibiotic dispensing practices in part I and part II pharmacies in Moshi Municipality, Kilimanjaro Region in Tanzania: A simulated clients approach

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Horumpende, Pius G., Sonda, Tolbert B., van Zwetselaar, Marco, Antony, Magreth L., Tenu, Filemon F., Mwanziva, Charles E., Shao, Elichilia R., Mshana, Stephen E., Mmbaga, Blandina T., Chilongola, Jaffu O.·2018·PLOS ONE

DOI 10.1371/journal.pone.0207465PMC PMC6248976

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Abstract

Antibiotic dispensing without a prescription poses a threat to public health as it leads to excessive antibiotic consumption. Inappropriate antibiotic availability to the community has been documented to be amongst drivers of antimicrobial resistance emergence. Community pharmacies are a source of antibiotics in low and middle-income countries (LMICs). We aimed at assessing antibiotic dispensing practices by community pharmacy retailers in Moshi urban, Kilimanjaro, Tanzania and recommend interventions to improve practice. Using a Simulated Client (SC) Method, an observational cross-sectional survey of antibiotic dispensing practices was conducted from 10th June to 10th July 2017. Data analysis was done using Stata 13 (StataCorp, College Station, TX, USA). A total of 82 pharmacies were visited. Part I pharmacies were 26 (31.71%) and 56 (68.29%) were part II. Overall 92.3% (95% CI 77.8-97.6) of retailers dispensed antibiotics without prescriptions. The antibiotics most commonly dispensed without a prescription were ampiclox for cough (3 encounters) and azithromycin for painful urination (3 encounters). An oral third generation cephalosporin (cefixime) was dispensed once for painful urination without prescription by a part I pharmacy retailer. Out of 21, 15(71.43%) prescriptions with incomplete doses were accepted and had antibiotics dispensed. Out of 68, 4(5.9%) retailers gave instructions for medicine use voluntarily. None of the retailers voluntarily explained drug side-effects. In Moshi pharmacies, a high proportion of antibiotics are sold and dispensed without prescriptions. Instructions for medicine use are rarely given and none of the retailers explain side effects. These findings support the need for a legislative enforcement of prescription-only antibiotic dispensing rules and regulations. Initiation of clinician and community antibiotic stewardship and educational programs on proper antibiotic use to both pharmacists and public by the regulatory bodies are highly needed.

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Authors: Horumpende, P. G., Sonda, T. B., van Zwetselaar, M., Antony, M. L., Tenu, F. F., Mwanziva, C. E., Shao, E. R., Mshana, S. E., Mmbaga, B. T., & Chilongola, J. O.
Affiliations: Kilimanjaro Clinical Research Institute (TZ)
Catholic University of Health and Allied Sciences (TZ)
Corresponding author: Horumpende, Pius G.
Sonda, Tolbert B.
Antony, Magreth L.
Mwanziva, Charles E.
Shao, Elichilia R.
Mshana, Stephen E.
Mmbaga, Blandina T.
Chilongola, Jaffu O.
ORCID: Horumpende, Pius G.
Sonda, Tolbert B.
van Zwetselaar, Marco
Shao, Elichilia R.
Mshana, Stephen E.
Mmbaga, Blandina T.
Chilongola, Jaffu O.
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2018-11-21
Volume: 13
Issue: 11
Pages: e0207465
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0207465
PMC: PMC6248976
OpenAlex: W2901854350
Cited by: 124
References: 60
Citations by year: 2026: 6 · 2025: 6 · 2024: 17 · 2023: 14 · 2022: 25 · 2021: 31 · 2020: 21 · 2019: 4
FWCI: 8.54
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics: Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
Keywords: community pharmacy, antimicrobial resistance, antibiotic stewardship, incomplete prescriptions, medication instructions, simulated clients, Moshi Municipality, Tanzania
MeSH terms: Anti-Bacterial Agents, Community Pharmacy Services, Cross-Sectional Studies, Female, Humans, Male, Pharmacists, Drug Prescriptions, Surveys and Questionnaires, Tanzania, Azithromycin, Cefixime, Drug-Related Side Effects and Adverse Reactions

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Prescription and non-prescription antibiotic dispensing practices in part I and part II pharmacies in Moshi Municipality, Kilimanjaro Region in Tanzania: A simulated clients approach

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