ArticleBMJ global health2019
Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India.
Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Non-prescription antibiotics dispensing for common infections using simulated patients.Exploratory research in clinical and social pharmacy · 2026Article
- Antibiotic purchasing through online pharmacies: A mystery shopper study.Journal of Taibah University Medical Sciences · 2025Article
- Medication Recommendation, Counseling, and Pricing for Nasal Sprays in German Community Pharmacies: A Simulated Patient Investigation.Advances in respiratory medicine · 2025Article
- Antimicrobial resistance: Past, present, and way forward.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2024Article
- Predicting over-the-counter antibiotic use in rural Pune, India, using machine learning methods.Epidemiology and health · 2024Article
- Article
- Private pharmacies as healthcare providers in Odisha, India: analysis and implications for universal health coverage.BMJ global health · 2023Article
- Evaluation of routine practices of dispensing pattern among community pharmacists in Can Tho city, Vietnam: A cross-sectional simulated patient approach.Journal of public health research · 2023Article
- Gender and urban-rural influences on antibiotic purchasing and prescription use in retail drug shops: a one health study.BMC public health · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Tuberculosis diagnosis and management in the public versus private sector: a standardised patients study in Mumbai, India.BMJ global health · 2022Article
- The role of Schedule H1 and Red Line campaign in improving antibiotic use in India.Journal of family medicine and primary care · 2022Article
- Keeping It Real: Antibiotic Use Problems and Stewardship Solutions in Low- and Middle-income Countries.The Pediatric infectious disease journal · 2022Article
- Marketing and Distribution System Foster Misuse of Antibiotics in the Community: Insights from Drugs Wholesalers in India.Antibiotics (Basel, Switzerland) · 2022Article
- Medication selection for the treatment of acute infective diarrhea in Thai pharmacies: a qualitative study.Translational and clinical pharmacology · 2021Article
- Mapping the Antimicrobial Supply Chain in Bangladesh: A Scoping-Review-Based Ecological Assessment Approach.Global health, science and practice · 2021Article
- 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
- Sales of antibiotics and hydroxychloroquine in India during the COVID-19 epidemic: An interrupted time series analysis.PLoS medicine · 2021Article
- Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review.Antibiotics (Basel, Switzerland) · 2020Review
- Antibiotic overuse in the primary health care setting: a secondary data analysis of standardised patient studies from India, China and Kenya.BMJ global health · 2020Article
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7 authors.
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Abstract
backgroundAntimicrobial resistance is a global health emergency, and one of the contributing factors is overuse and misuse of antibiotics. India is one of the world's largest consumers of antibiotics, and inappropriate use is potentially widespread. This study aimed to use standardised patients (SPs) to measure over-the-counter antibiotic dispensing in one region.
methodsThree adults from the local community in Udupi, India, were recruited and trained as SPs. Three conditions, in both adults and children, were considered: diarrhoea, upper respiratory tract infection and acute fever. Adult SPs were used as proxies for the paediatric cases.
resultsA total of 1522 SP interactions were successfully completed from 279 pharmacies. The proportion of SP interactions resulting in the provision of an antibiotic was 4.34% (95% CI 3.04% to 6.08%) for adult SPs and 2.89% (95% CI 1.8% to 4.4%) for child SPs. In the model, referral to another provider was associated with an OR 0.38 (95% CI 0.18 to 0.79), the number of questions asked was associated with an OR 1.54 (95% CI 1.30 to 1.84) and an SP-pharmacist interaction lasting longer than 3 min was associated with an OR 3.03 (95% CI 1.11 to 8.27) as compared with an interaction lasting less than 1 min.
conclusionOver-the-counter antibiotic dispensing rate was low in Udupi district and substantially lower than previously published SP studies in other regions of India. Dispensing was lowest when pharmacies referred to a doctor, and higher when pharmacies asked more questions or spent more time with clients.
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