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Cited by 42Antibiotic Use and ResistancePharmacy and Medical PracticesPharmaceutical industry and healthcare

Pharmacists’ practices for non-prescribed antibiotic dispensing in Mozambique

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Torres, `Neusa, Solomon, Vernon, Middleton, Lyn·2020·Pharmacy Practice
DOI 10.18549/pharmpract.2020.3.1965PMC PMC7470239
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Abstract

Background: Antibiotics are the most frequently used medicines worldwide with most of the countries defining these as prescription-only medicines. Though, dispensing non-prescribed antibiotics represent one of the chief causal factors to the irrational use of antibiotics that paves the way to the development of antimicrobial resistance. Objective: We aimed at describing the practices and the enablers for non-prescribed antibiotic dispensing in Maputo city, Mozambique. Methods: A qualitative study was conducted, between October 2018 and March 2019, in nine private pharmacies randomly selected across Maputo city. Eighteen pharmacists were contacted and seventeen enrolled through snowball sampling. In-depth interviews were conducted, audiotaped, and transcribed verbatim. Transcripts were coded and analysed though thematic analysis with guidelines from Braun and Clark. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist by (Tong, 2007) was performed. Results: Out of seventeen, fifteen pharmacists admitted non-prescribed dispensing of antibiotics. Common antibiotic dispensing practices included; dispensing without prescription, without asking for a brief clinical history of patients, without clear explanation of the appropriate way of administering, without advising on the side effects. Reasons for non-prescribed antibiotic dispensing are linked to patients’ behaviour of demanding for non-prescribed antibiotics, to the patients expectations and beliefs on the healing power of antibiotics, to the physicians’ prescribing practices. Other reasons included the pressure for profits from the pharmacy owners, the fragile law enforcement, and absence of accountability mechanisms. Conclusions: The practices of non-prescribed antibiotic dispensing characterize the ‘daily life’ of the pharmacists. On the one hand, the patient’s demand for antibiotics without valid prescriptions, and pharmacist’s wish to assist based on their role in the pharmacy, the pressure for profits and on the understanding of the larger forces driving the practices of self-medication with antibiotics - rock. On the other hand, pharmacists are aware of the legal status of antibiotics and the public health consequences of their inappropriate dispensing practices and their professional and ethical responsibility for upholding the law - hard place. Highlighting the role of pharmacists and their skills as health promotion professionals is needed to optimizing antibiotic dispensing and better conservancy in Mozambique.

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  • Recent reports show that pharmacists dispensed antibiotics without prescriptions or consumers visit pharmacies to buy antibiotics as OTC medicine in Bangladesh, China, Mozambique, Thailand, and India.

    “There are a few recent reports showing that pharmacists dispensed antibiotics without prescriptions or that consumers visit pharmacies to buy antibiotics as OTC medicine, e.g., in Bangladesh [16], China [17], Mozambique [18], Thailand [19], and India [20].”

    From Over-the-Counter Sale of Antibiotics in India: A Qualitative Study of Providers’ Perspectives across Two States (2021) · cites this paper as [18]

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Authors
Torres, `., Solomon, V., & Middleton, L.
Affiliations
  • Instituto Superior de Ciencias de Saude (MZ)
  • University of KwaZulu-Natal (ZA)
ORCID
Venue
Pharmacy Practice
Publisher
JCFCorp SG PTE LTD
Published
2020-08-18
Volume
18
Issue
3
Pages
1965
ISSN
  • 1885-642X (ISSN-L)
  • 1886-3655
DOI
10.18549/pharmpract.2020.3.1965
PMC
PMC7470239
OpenAlex
W3068901234
Cited by
42
References
4
Citations by year
2026: 4 · 2025: 7 · 2024: 6 · 2023: 6 · 2022: 10 · 2021: 5 · 2020: 4
FWCI
3.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Pharmacy Practice (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Dialnet (Universidad de la Rioja) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Redalyc (Universidad Autónoma del Estado de México) (submittedVersion)
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
inappropriate antibiotic use, antimicrobial resistance, antibiotic self-medication, prescription-only medicines, private pharmacies, Maputo

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