ArticleBMC infectious diseases2010
Cross-sectional study of availability and pharmaceutical quality of antibiotics requested with or without prescription (Over The Counter) in Surabaya, Indonesia.
Article in BMC infectious diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence and Estimated Economic Burden of Substandard and Falsified Medicines in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.JAMA network open · 2018Pooled it
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- Views, Barriers and Facilitators of Policymakers, Pharmacists and Community Health Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia.F1000Research · 2026Article
- Antimicrobial use for influenza-like illnesses in Nha Trang, Vietnam: a cross-sectional study.BMJ open · 2025Observational
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- Building an effective medicines optimisation model: a health system approach.International journal of clinical pharmacy · 2024Article
- Community Pharmacies in the Asian Countries of Developing Health System: Formation, Regulation, and Implication.Pharmacy (Basel, Switzerland) · 2023Article
- Substandard and falsified antibiotics: neglected drivers of antimicrobial resistance?BMJ global health · 2022Article
- The potential roles of pharmacy medication sales data to augment the syndromic surveillance system in response to COVID-19 and preparedness for other future infectious disease outbreaks in Indonesia.The International journal of health planning and management · 2022Article
- Drug shops for stronger health systems: learning from initiatives in six LMICs.Journal of pharmaceutical policy and practice · 2021Review
- Prevalence and determinants of inappropriate antibiotic dispensing at private drug retail outlets in urban and rural areas of Indonesia: a mixed methods study.BMJ global health · 2021Article
- Educational Video Improves Knowledge about Outpatients' Usage of Antibiotics in Two Public Hospitals in Indonesia.Antibiotics (Basel, Switzerland) · 2021Article
- Ten recommendations to improve pharmacy practice in low and middle-income countries (LMICs).Journal of pharmaceutical policy and practice · 2021Article
- Quality assessment of selected co-trimoxazole suspension brands marketed in Nairobi County, Kenya.PloS one · 2021Article
- Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review.Antibiotics (Basel, Switzerland) · 2020Review
- A cross-sectional analysis of falsified, counterfeit and substandard medicines in a low-middle income country.BMC public health · 2020Article
- Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting.Antibiotics (Basel, Switzerland) · 2020Review
- Tackling antimicrobial resistance in Bangladesh: A scoping review of policy and practice in human, animal and environment sectors.PloS one · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial resistance is an increasing problem in developing countries and antibiotic use is widespread. Our previous surveys in Java, Indonesia, revealed that most antibiotic use was probably unnecessary or ineffective. The aim of this study was to explore a potential connection between resistance and substandard antibiotics sold in the area.
methodsA cross-sectional field study using the simulated client method was conducted in Surabaya. Five first-line antibiotics were requested with or without prescription (OTC). A certified laboratory analysed the drug content using validated methods. Possible determinants of substandard quality were explored.
resultsIn total, 104 samples from 75 pharmacies, ten drug stores and 39 roadside stalls (kiosks) were obtained. Pharmacy employees filled all OTC requests. Three quarters of kiosks sold antibiotics. Antibiotics were dispensed as single blister strips or repackaged (16%) without label. Ninety five percent of samples carried the label of 14 Indonesian manufacturers. The pharmaceutical quality did not meet BP standards for 18% of samples. Deviations (less active ingredient) were small. There was no association between low content and type of outlet, sold with or without prescription, registration type, price or packaging. Median retail prices of products carrying the same label varied up to 20 fold.
conclusionsAntibiotics were available OTC in all visited pharmacies and sold in the streets of an Indonesian city. Most samples contained an active ingredient. We urge to increase enforcement of existing regulations, including legislation that categorizes antibiotics as prescription-only drugs for all types of medicine outlets, to limit further selection of antimicrobial resistance.
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