ArticleBMJ global health2021
Prevalence and determinants of inappropriate antibiotic dispensing at private drug retail outlets in urban and rural areas of Indonesia: a mixed methods study.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
25 citing papers in PubMed, 1 synthesis or guideline 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
- Multidrug-Resistant Gram-Negative Bacteremia among Pediatric Oncology Patients with Neutropenic Fever: Associated Risk Factors and Mortality Outcomes.Infection & chemotherapy · 2026Article
- "Miss, I want itchy medicine": Understanding what, why, and how antibiotics are used in Central Java province, Indonesia through the drug bag method.PLOS global public health · 2026Article
- Barriers and enablers in implementing integrated primary health care: A qualitative assessment in West Sumbawa District, Indonesia.PLOS global public health · 2026Article
- Meta-analysis of randomized controlled trials of electronic health interventions to reduce medication errors.NPJ digital medicine · 2025Article
- 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
- Article
- Article
- Antibiotics governance in aquaculture: knowledge, practices, and challenges among stakeholders on the Volta Lake in Ghana.One health outlook · 2025Article
- A Simulated Client Study on Non-Prescription Antibiotic Sales and Counselling Practices in Iraqi Nurse-Led Clinics: Implications for Antimicrobial Resistance.Infection and drug resistance · 2025Article
- Phylogenetic analysisOpen veterinary journal · 2024Article
- 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
- Assessment of factors associated with self-medication practices during the COVID-19 pandemic in southwestern Ethiopia: a community-based cross-sectional survey.BMC infectious diseases · 2024Article
- Antibiotic Utilization and Its Implications Among Ruminant Farmers and Stakeholders in Sumbawa Regency, Indonesia.Veterinary medicine international · 2024Article
- Gender and urban-rural influences on antibiotic purchasing and prescription use in retail drug shops: a one health study.BMC public health · 2023Article
- Microbiomes in Acne Vulgaris and Their Susceptibility to Antibiotics in Indonesia: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2023Review
- Mapping access to drug outlets in Vietnam: distribution of drug outlets and the sociodemographic characteristics of the communities they serve.The Lancet regional health. Western Pacific · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Article
- Optimizing antibiotic use in Indonesia: A systematic review and evidence synthesis to inform opportunities for intervention.The Lancet regional health. Southeast Asia · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of this mixed-method study was to determine the extent and determinants of inappropriate dispensing of antibiotics by licensed private drug retail outlets in Indonesia.
methodsStandardised patients (SPs) made a total of 495 visits to 166 drug outlets (community pharmacies and drug stores) between July and August 2019. The SPs presented three clinical cases to drug outlet staff: parent of a child at home with diarrhoea; an adult with presumptive tuberculosis (TB); and an adult with upper respiratory tract infection (URTI). The primary outcome was the dispensing of an antibiotic without prescription, with or without the client requesting it. We used multivariable random effects logistic regression to assess factors associated with the primary outcome and conducted 31 interviews with drug outlet staff to explore these factors in greater depth.
resultsAntibiotic dispensing without prescription occurred in 69% of SP visits. Dispensing antibiotics without a prescription was more likely in standalone pharmacies and pharmacies attached to clinics compared with drug stores, with an OR of 5.9 (95% CI 3.2 to 10.8) and OR of 2.2 (95% CI 1.2 to 3.9); and more likely for TB and URTI SP-performed cases compared with child diarrhoea cases, with an OR of 5.7 (95% CI 3.1 to 10.8) and OR of 5.2 (95% CI 2.7 to 9.8). Interviews revealed that inappropriate antibiotic dispensing was driven by strong patient demand for antibiotics, unqualified drug sellers dispensing medicines, competition between different types of drug outlets, drug outlet owners pushing their staff to sell medicines, and weak enforcement of regulations.
conclusionThis study shows that inappropriate dispensing of antibiotics by private drug retail outlets is widespread. Interventions will need to address not only the role of drug sellers, but also the demand for antibiotics among clients and the push from drug outlet owners to compete with other outlets.
Indexed as
Identifiers
What OpenQuestion holds
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.