Over-the-counter antibiotic sales in community and online pharmacies, China
Open accessAbstract
Objective To determine the prevalence of and factors associated with dispensing antibiotics without a prescription in online and community pharmacies in China. MethodsWe conducted a nationwide cross-sectional study of online and community pharmacies in 27 cities and counties in nine provinces in China (selected by multistage sampling) from July 2017 to December 2018.We assessed sale of antibiotics without a prescription and quality of pharmacy services through simulated clients who asked to buy specific antibiotics.We compared the prevalence of sales between online and community pharmacies, and between location and features of community pharmacies.Findings Of 220 online and 675 community pharmacies, 174 (79.1%) and 586 (86.8%) sold antibiotics without a valid prescription, respectively.About half of the online pharmacies had a notice on their website about the illegality of selling prescription-only medicines without a prescription while none of the community pharmacists had.More online pharmacies without this notice dispensed antibiotics without a valid prescription (P < 0.001).Antibiotics' sale without a prescription was significantly less prevalent in provincial capital cities (71.6%; 161/225) than prefectural-level cities (95.1%; 214/225) and counties (93.8%; 211/225; P < 0.001).Most pharmacy staff did not ask for important information from clients before dispensing the antibiotic or provide them with necessary information about the antibiotic.Conclusion Given the high proportion of sales of prescription-only medicines without a prescription, there is a need to strengthen enforcement of regulations, improve public education on antibiotics, train pharmacy staff and consolidate public involvement in antibiotic stewardship in retail pharmacies in China.
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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 [17]
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“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].”
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- Authors
- Gong, Y., Jiang, N., Chen, Z., Wang, J., Zhang, J., Feng, J., Lu, Z., & Yin, X.
- Affiliations
- Huazhong University of Science and Technology (CN)
- Corresponding author
- Yin, Xiaoxv
- Venue
- Bulletin of the World Health Organization
- Publisher
- WHO Press
- Published
- 2020-04-21
- Volume
- 98
- Issue
- 7
- Pages
- 449-457
- ISSN
- 0042-9686 (ISSN-L)
- PMC
- PMC7375218
- OpenAlex
- W3038483894
- Cited by
- 55
- References
- 19
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 8 · 2023: 14 · 2022: 11 · 2021: 9 · 2020: 1
- FWCI
- 5.22
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Bulletin of the World Health Organization (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (71874060)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pharmaceutical Quality and Counterfeiting
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- over-the-counter antibiotic sales, prescription-only medicines, online pharmacies, community pharmacy, antibiotic stewardship, simulated clients, antibiotic misuse, China
- MeSH terms
- Anti-Bacterial Agents, China, Commerce, Community Pharmacy Services, Cross-Sectional Studies, Humans, Pharmacies, Drug Prescriptions, Surveys and Questionnaires, Illicit Drugs, Pharmaceutical Services, Online
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