SynthesisBMC public health2021
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.
Synthesis in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 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.
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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.
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Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Non-prescription antibiotic dispensing in community pharmacies in LMICs: a systematic review of prevalence, drivers, and policy implications.BMC health services research · 2026Pooled it
- 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
- Protocols, policies and practices for antimicrobial stewardship in hospitalized patients in least-developed and low-income countries: a systematic review.Antimicrobial resistance and infection control · 2023Pooled it
- Non-prescription antibiotic dispensing in community pharmacies in jordan: a simulated patient study.The Libyan journal of medicine · 2026Article
- Prevalence and determinants of psychotropic drug self-medication among medical students at the university of Gondar, Ethiopia: the role of mental health stigma.Scientific reports · 2026Article
- The Difluoroboranyl-Fluoroquinolone Derivative "7a" Inhibits Bacterial DNA Gyrase and Exhibits Potent Activity Against Ciprofloxacin-ResistantMolecules (Basel, Switzerland) · 2026Article
- Prescription-only medicine requests by clients: Insights from community pharmacies.Exploratory research in clinical and social pharmacy · 2026Article
- Climate change and antimicrobial resistance in the Western Pacific: a mixed-methods systematic analysis.The Lancet regional health. Western Pacific · 2026Article
- Psychometric Validation of the Community Antimicrobial Use Scale (CAMUS) in Primary Healthcare and the Implications for Future Use.Antibiotics (Basel, Switzerland) · 2026Article
- A point prevalence survey on antibiotic dispensing practices identifies targets for quality improvement of antimicrobial stewardship in community pharmacies in Dar es Salaam, Tanzania.Journal of pharmaceutical policy and practice · 2026Article
- Views, Barriers and Facilitators of Policymakers, Pharmacists and Community Health Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia.F1000Research · 2026Article
- Surveying Self-Medication Practices and Attitudes Toward Antibiotic Use Among Adults in Primary Care.Cureus · 2025Article
- Knowledge, attitudes and practices survey on antimicrobial resistance and stewardship among pharmacy healthcare workers in 28 African countries.BMJ global health · 2025Article
- Antibiotic dispensing practices in community pharmacies: Implications for antimicrobial stewardship in resource-constrained settings.Exploratory research in clinical and social pharmacy · 2025Article
- Antibiotic use without prescription among children aged under 5 years in low- and middle-income countries: a systematic review and meta-analysis.JAC-antimicrobial resistance · 2025Review
- Assessing community antibiotic usage and adherence as per standard treatment guidelines: A potential area to enhance awareness at community pharmacy settings.Exploratory research in clinical and social pharmacy · 2025Article
- Antibiotics stewardship: prevalence, nature, and factors associated with dispensing of antibiotics without prescription among community pharmacists in Nigeria.Journal of pharmaceutical policy and practice · 2025Article
- A qualitative study on factors influencing health workers' uptake of a pilot surgical antibiotic prophylaxis stewardship programme in selected Georgian hospitals.PLOS global public health · 2025Article
- The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia: a mixed methods evaluation.BMJ global health · 2024Article
- Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence.JAC-antimicrobial resistance · 2024Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-prescription dispensing of antibiotics, one of the main sources of antibiotic misuse or over use, is a global challenge with detrimental public health consequences including acceleration of the development of antimicrobial resistance, and is facilitated by various intrinsic and extrinsic drivers. The current review aimed to systematically summarise and synthesise the qualitative literature regarding drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries.
methodsFour electronic databases (PubMed, CINAHL, Scopus and Google Scholar) and reference lists of the relevant articles were searched. The Joanna Briggs Institute's Critical Appraisal Checklist for qualitative studies was used to assess the quality of included studies. The enhancing transparency in reporting the synthesis of qualitative research statement was used to guide reporting of results. Data were coded using NVivo 12 software and analysed using both inductive and deductive thematic analysis.
resultsA total of 23 articles underwent full text review and 12 of these met the inclusion criteria. Four main themes were identified in relation to facilitators of non-prescribed sale of antibiotics among community drug retail outlets: i) the business orientation of community drug retail outlets and tension between professionalism and commercialism; ii) customers' demand pressure and expectation; iii); absence of or a lax enforcement of regulations; and iv) community drug retail outlet staff's lack of knowledge and poor attitudes about antibiotics use and scope of practice regarding provision.
conclusionsThis review identified several potentially amendable reasons in relation to over the counter dispensing of antibiotics. To contain the rise of antibiotic misuse or over use by targeting the primary drivers, this review suggests the need for strict law enforcement or enacting new strong regulation to control antibiotic dispensing, continuous and overarching refresher training for community drug retail outlet staff about antibiotic stewardship, and holding public awareness campaigns regarding rational antibiotic use.
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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.