SynthesisAntimicrobial resistance and infection control2021
Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis.
Synthesis in Antimicrobial resistance and infection control, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
104 citing papers in PubMed, 6 syntheses or guidelines pooled it, 177 citations in OpenAlex.
- Non-prescription antibiotic use and its predictors among children in low- and middle-income countries: a systematic review and meta-analysis.Italian journal of pediatrics · 2024Pooled it
- Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Prevalence of fever of unidentified aetiology in East African adolescents and adults: a systematic review and meta-analysis.Infectious diseases of poverty · 2023Pooled it
- Pooled it
- Economic evaluation of antimicrobial stewardship in primary care: a systematic review and quality assessment.The Journal of antimicrobial chemotherapy · 2022Pooled it
- No prescription? No problem: drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries: a systematic review of qualitative studies.BMC public health · 2021Pooled it
- Trial
- Point-of-care testing in community pharmacies to improve antimicrobial stewardship in respiratory infections: a scoping review of effectiveness, implementation and cost-effectiveness-right-to-reply.JAC-antimicrobial resistance · 2026Article
- High prevalence of antibiotic purchase without prescription in community pharmacies in Bucaramanga, Colombia.IJID regions · 2026Article
- Article
- Frequency and characteristics of extended-spectrum beta-lactamase-producing Escherichia coli in wastewater in Dakar, Senegal.BMC research notes · 2026Article
- Human wastewater contamination drives the emergence of multidrug-resistant bacteria in the Galápagos marine ecosystem.Nature communications · 2026Article
- From classrooms to practice: does pre-service training for one health professions provide readiness for antimicrobial stewardship?BMC medical education · 2026Article
- A message to Africa as Nigeria hosts the 5th Global High-Level Ministerial Conference on antimicrobial resistance.Antimicrobial resistance and infection control · 2026Article
- Expectations Shaped Elsewhere: Refugee Experiences of Healthcare in Aotearoa New Zealand.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Over-the-counter sales of high-priority antibiotics are common: results of a global survey.JAC-antimicrobial resistance · 2026Article
- Article
- High gastrointestinal carriage rates of extended-spectrum-β-lactamase-producing enterobacterales and associated factors among hospitalized and nonhospitalized children in Kenya.Scientific reports · 2026Article
- Standardizing Antimicrobial Use in a Resource-Limited Pediatric Surgical Unit in Botswana.Open forum infectious diseases · 2026Article
- Psychometric Validation of the Community Antimicrobial Use Scale (CAMUS) in Primary Healthcare and the Implications for Future Use.Antibiotics (Basel, Switzerland) · 2026Article
44 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community.
objectiveThe current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed.
methodsA literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies.
resultsOf 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58-80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms.
conclusionsNon-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.