ArticleInfection and drug resistance2021
A Simulated Client Exploration of Nonprescription Dispensing of Antibiotics at Drugstores for Pediatric Acute Diarrhea and Upper Respiratory Infection in Lahore, Pakistan.
Article in Infection and drug resistance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Non-prescription antibiotics dispensing for common infections using simulated patients.Exploratory research in clinical and social pharmacy · 2026Article
- Using Unannounced Standardized Patients to Assess the Quality of Tuberculosis Care and Antibiotic Prescribing: A Cross-Sectional Study on a Low/Middle-Income Country, Pakistan.Antibiotics (Basel, Switzerland) · 2025Article
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
- Evaluation of pharmacists' opioid dispensing practices: a cross-sectional study from Pakistan.Journal of pharmaceutical policy and practice · 2025Article
- Non-prescription dispensing of veterinary medicines for treating mastitis in dairy cattle among non-veterinary personnel in selected districts of Zambia.Frontiers in veterinary science · 2025Article
- A Scoping Review of Pakistani Healthcare Simulation: Insights for Lower-Middle-Income Countries.Cureus · 2024Review
- Non-prescription sale and dispensing of antibiotics for prophylaxis in broiler chickens in Lusaka District, Zambia: findings and implications on one health.JAC-antimicrobial resistance · 2024Article
- The Enterics for Global Health (EFGH)Open forum infectious diseases · 2024Article
- Non-prescription antibiotics dispensing by community pharmacies: implications for antimicrobial resistance.Annals of medicine and surgery (2012) · 2023Article
- Using the Simulated Patient Method to Evaluate the Community Pharmacy Management of Childhood Diarrhoea: A Systematic Review.The Malaysian journal of medical sciences : MJMS · 2023Review
- Understanding of Final Year Medical, Pharmacy and Nursing Students in Pakistan towards Antibiotic Use, Antimicrobial Resistance and Stewardship: Findings and Implications.Antibiotics (Basel, Switzerland) · 2023Article
- The Extent of Antibiotic Dispensing in Self-Medication Encounters in Sudan: A Simulated Patient Study Focusing on Cefixime Sale.Integrated pharmacy research & practice · 2023Article
- Non-prescribed antibiotic use for children at community levels in low- and middle-income countries: a systematic review and meta-analysis.Journal of pharmaceutical policy and practice · 2022Article
- Exploring Knowledge of Antibiotic Use, Resistance, and Stewardship Programs among Pharmacy Technicians Serving in Ambulatory Care Settings in Pakistan and the Implications.Antibiotics (Basel, Switzerland) · 2022Article
- Self-Medication with Antibiotics: Prevalence, Practices and Related Factors among the Pakistani Public.Antibiotics (Basel, Switzerland) · 2022Article
- Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan.International journal of environmental research and public health · 2022Article
- Understanding of Future Prescribers About Antimicrobial Resistance and Their Preparedness Towards Antimicrobial Stewardship Activities in Pakistan: Findings and Implications.Frontiers in pharmacology · 2022Article
- Antimicrobial Use and Management of Childhood Diarrhea at Community Drug Retail Outlets in Eastern Ethiopia: A Matched Questionnaire-Based and Simulated Patient-Case Study.Pediatric health, medicine and therapeutics · 2022Article
- Article
- Effectiveness of Pharmacist-Led Brief Educational Intervention for Adherence to the Antibiotics for Lower Respiratory Tract Infections (EATSA) in Post-Conflict Rural Areas of Pakistan: Study Protocol for a Randomized Controlled Trial.Antibiotics (Basel, Switzerland) · 2021Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe excessive consumption of antibiotics is a significant contributor to antimicrobial resistance, especially in children. Children are often advised antibiotics for viral infections. In developing countries, drugstores are a prime source of easy access to nonprescription antibiotics. Moreover, in Pakistan, their irrational use is an "everyday routine". The study, therefore, aimed to evaluate the dispensing of nonprescription antibiotics to children.
methodsUsing pediatric acute diarrhea and acute upper respiratory infection as disease scenarios, a simulated client, cross-sectional study was conducted in Lahore, Pakistan, to explore the antibiotics' ease of availability at both categories of drugstores (pharmacies and medical stores) from November 1st, 2019 to January 31st, 2020. Chi-square (
resultsAntibiotics were dispensed without prescription in 456 (59%) of 773 simulated visits out of which 425 (93.2%) were dispensed on the advice of the drugstore staff. A qualified pharmacist was available in only 164 (21.2%) cases. Of the 386 visits for acute diarrhea and 387 for acute upper respiratory infection, nonprescription antibiotic dispensing occurred in 259 (67.1%) and 197 (50.9%) visits, respectively. There were considerable differences (p-value <0.05) in the practices and antibiotics dispensing between each disease scenario presented. Moreover, antibiotics were less commonly dispensed at pharmacist-supervised drugstores compared to unsupervised ones.
conclusionOverall, inappropriate dispensing practices were prevalent to a large extent at the drugstores, and antibiotics were effortlessly obtainable without prescription. The quality of the services provided, especially by the non-pharmacist staff, was also not satisfactory. Therefore, the Drug Regulating Authority of Pakistan must enforce strict implementation of drug laws at the drugstores without delay, especially in major cities to help curb the felonious use of antibiotics.
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