ArticleAntimicrobial resistance and infection control2020
Widespread illegal sales of antibiotics in Chinese pharmacies - a nationwide cross-sectional study.
Article in Antimicrobial resistance and infection control, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of systemic antibacterial use during pregnancy worldwide: A systematic review.PloS one · 2024Pooled it
- Factors influencing inappropriate use of antibiotics in outpatient and community settings in China: a mixed-methods systematic review.BMJ global health · 2020Pooled it
- Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Trial
- Guideline Concordance and Antimicrobial Stewardship in Community Pharmacy Management of Suspected Pediatric Acute Otitis Media: A Simulated Patient Study in Saudi Arabia.Healthcare (Basel, Switzerland) · 2026Article
- Home is where the host is: evolutionary history of geographic spread, host switching and adaptive genomic signatures in two generalist group BMicrobial genomics · 2026Article
- Genomic insights into the spread of methicillin-resistant Staphylococcus aureus involved in ear infections.BMC infectious diseases · 2025Article
- Unveiling the drivers of vancomycin-resistant enterococcus in China: A comprehensive ecological study.Infectious medicine · 2025Article
- Article
- Subsidized veterinary extension services may reduce antimicrobial resistance in aquaculture.Scientific reports · 2023Article
- Sales of antibiotics without a prescription in pharmacies, 2017 and 2021, China.Bulletin of the World Health Organization · 2023Article
- Antibiotic Culture: A History of Antibiotic Use in the Second Half of the 20th and Early 21st Century in the People's Republic of China.Antibiotics (Basel, Switzerland) · 2023Article
- Use of antibiotics and other treatments in Chinese adults with acute cough: An online survey.Integrative medicine research · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Impact of the COVID-19 Outbreak on the Antibiotic Use Patterns among a Rural Community Population in Eastern China.Antibiotics (Basel, Switzerland) · 2022Article
- Antibiotic Stewardship in Retail Pharmacies and the Access-Excess Challenge in China: A Policy Review.Antibiotics (Basel, Switzerland) · 2022Review
- Understanding parental self-medication with antibiotics among parents of different nationalities: a cross-sectional study.Global health research and policy · 2021Article
- The General Population's Inappropriate Behaviors and Misunderstanding of Antibiotic Use in China: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2021Review
- Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review.Antibiotics (Basel, Switzerland) · 2020Review
- Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China.Antimicrobial resistance and infection control · 2020Article
- Over-the-counter antibiotic sales in community and online pharmacies, China.Bulletin of the World Health Organization · 2020Article
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4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Access to antibiotics without a prescription from retail pharmacies has been described as a major contributor to anti-microbial resistance (AMR) globally. In the context of high rates of AMR, the Chinese government has recently introduced strict policies regarding hospital antibiotic use, but the existing ban on antibiotic sales without prescription in retail pharmacies has not been strongly enforced. In 2016, a goal of prescription-only antibiotics by 2020 was announced. The objective of the study was to determine progress towards the 2020 goal, through estimating the proportion of retail pharmacies selling antibiotics without prescription across the three regions of mainland China. Methods: Using the Simulated Patient method, we conducted a cross-sectional survey across purposively-sampled retail pharmacies in urban and rural areas of 13 provinces in eastern, central and western China. Medical students presented a scenario of a mild upper respiratory tract infection, following a strict three-step protocol. They recorded the pharmacy characteristics, and details of their experience, including at which step antibiotics were offered. Results: Complete data were obtained from 1106 pharmacies. Antibiotics were obtained in 925 (83.6, 95% CI: 81.5, 85.8%) pharmacies without a prescription, 279 (25.2%) at Stage 1 (symptoms only described), 576 (52.1%) at stage 2 (asked for antibiotics), and 70 (6.3%) at Stage 3 (asked for penicillin or cephalosporins). There were significant differences between provinces, with antibiotic access (at any stage) ranging from 57.0% (57/100) in Zhejiang (81/82) to 98.8% in Guizhou. However, there were no significant differences in access to antibiotics by level of city, county, township or village ( Conclusions: It is easy to obtain antibiotics without a prescription in retail pharmacies in China, despite the fact it is against the law. This must be addressed as part of the wider anti-microbial stewardship effort which could include intense enforcement of the existing law, supported by a public education campaign.
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