ArticleJournal of pharmaceutical policy and practice2020
Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study.
Article in Journal of pharmaceutical policy and practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.
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Who cites it
56 citing papers in PubMed.
- Non-prescription antibiotics dispensing for common infections using simulated patients.Exploratory research in clinical and social pharmacy · 2026Article
- Trends in Antimicrobial Consumption in Pakistan (2016-2028): Retrospective Observational Study With Forecasting.JMIR public health and surveillance · 2026Observational
- Knowledge and attitudes towards antibiotics and antimicrobial resistance among patients in rural South Africa and the implications for future policies.Frontiers in pharmacology · 2026Article
- Prevalence and Associated Factors for Purchasing Antibiotics Without a Prescription Among Patients in Rural South Africa: Implications for Addressing Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2025Article
- Results from the Survey of Antibiotic Resistance (SOAR) 2018-21 in Pakistan: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.The Journal of antimicrobial chemotherapy · 2025Article
- Review on progress, challenges, and recommendations for implementing the One Health approach in the Eastern Mediterranean Region.One health (Amsterdam, Netherlands) · 2025Review
- Evaluating the Analgesic, Hemostatic, and Antimicrobial Potential of a Novel Herbal Formulation for Dental Use.Cureus · 2025Article
- Knowledge, Attitudes, and Practices of Iraqi Parents Regarding Antibiotic Use in Children and the Implications.Antibiotics (Basel, Switzerland) · 2025Article
- Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- A qualitative exploration of parental perspectives and behaviors on self-medication for children under five in Abbottabad, Pakistan.Frontiers in pediatrics · 2025Article
- Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
- Paediatricians' knowledge, perceptions, preparedness and involvement towards paediatric antimicrobial stewardship in Pakistan: findings and the implications.JAC-antimicrobial resistance · 2024Article
- Understanding the Determinants Influencing Self-Medication with Antibiotics Among Malaysian Residents: A Qualitative Study to Inform Preventive Public Health Strategies.Antibiotics (Basel, Switzerland) · 2024Article
- Longevity of immune response after a single dose of typhoid conjugate vaccine against Salmonella Typhi among children in Hyderabad, Pakistan.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Article
- Linezolid-resistant Enterococcus faecium clinical isolates from Pakistan: a genomic analysis.BMC microbiology · 2024Article
- Antimicrobial Resistance: Stewardship and One Health in the Eastern Mediterranean Region.Cureus · 2024Review
- Antibiotic Dispensing Practices Among Community Retail Pharmacies and Registered Drugstores: Results from a Simulated Client Study in Lilongwe, Malawi.Integrated pharmacy research & practice · 2024Article
- Antimicrobial Use Among Hospitalized Neonates and Children; Findings and Implications from a Comprehensive Point Prevalence Survey Among General Tertiary Hospitals in Pakistan.Infection and drug resistance · 2024Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionResistant strains of bacteria are rapidly emerging with increasing inappropriate use of antibiotics rendering them less efficacious. Self-purchasing of antibiotics particularly for viral infections is a key driver of inappropriate use, especially in lower- and middle-income countries. There is a particular issue in countries such as Pakistan. Consequently, there is a need to assess current rates of self-purchasing especially for reserve antibiotics to guide future policies.
aimsAssess the extent of current antibiotic sales without a prescription in urban areas of Pakistan. METHODOLOGY: A multicenter cross-sectional study was conducted in different areas of Punjab, Pakistan using Simulated Client technique. The investigators demanded different predefined antibiotics from WHO AWaRe groups without prescription. Three levels of demand were used to convince the pharmacy staff in order to dispense the antibiotic without a prescription. A data collection form was completed by simulated clients within 15 min of each visit.
resultsOverall 353 pharmacies and medical stores were visited out of which 96.9% pharmacies and medical stores dispensed antibiotics without demanding a prescription (82.7% at demand level 1 and 14.2% at demand level 2), with only 3.1% of pharmacies refusing to dispense antibiotics. The most frequently dispensed antibiotic was ciprofloxacin (22.1%). Surprisingly, even the reserve group antibiotics were also dispensed without a prescription. In only 25.2% visits, pharmacy staff guided patients about the use of antibiotics, and in only 11.0% pharmacists enquired about other medication history.
conclusionCurrently, antibiotics are easily acquired without a legitimate prescription in Pakistan. There is a need for strict adherence to regulations combined with a multi-dimensional approach to enhance appropriate dispensing of antibiotics and limit any dispensing of WHO restricted antibiotics without a prescription.
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