ArticleIntegrated pharmacy research & practice2024
Antibiotic Dispensing Practices Among Community Retail Pharmacies and Registered Drugstores: Results from a Simulated Client Study in Lilongwe, Malawi.
Article in Integrated pharmacy research & practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Patterns of antibiotic use among adult patients across seven hospitals in Malawi: opportunities and challenges for antimicrobial stewardship programmes.Journal of pharmaceutical policy and practice · 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
- Strengthening antimicrobial stewardship in public health facilities in Malawi through a participatory epidemiology approach.JAC-antimicrobial resistance · 2025Article
- Over-the-counter antimicrobial dispensing in Lusaka Province retail pharmacies, Zambia.JAC-antimicrobial resistance · 2025Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Antimicrobial resistance (AMR) is largely driven by the inappropriate use of antibiotics. This has been attributed to the non-prescription sale of antibiotics in retail drug outlets. Despite the rising number of retail drug outlets in Malawi, the practice of drug dispensing in private pharmacies has not been evaluated. This study therefore assessed the prevalence of non-prescription sales of antibiotics in retail drug outlets in Lilongwe, Malawi. Methods: A community-based simulated client cross-sectional study was conducted in Lilongwe, Malawi from December 2023 to February 2024 using mystery shopping. Data were analyzed using IBM SPSS software version 29 using both descriptive and Analytical statistics. We computed simple proportions and conducted a hypotheses test using Chi-Square to test for Significance. Results: Antibiotic dispensing practices were surveyed in 51 retail drug outlets comprising 36 retail pharmacies and 15 drugstores. 35.3% (n=18) of the drug outlets had drug dispensing done by pharmacists, 13.7% (n=7) by pharmacy technicians, 21.5% (n=11) by pharmacy assistants and 25.5% (n=15) by drug dispensers who had no pharmacy-related training. The rate of non-prescription sales of antibiotics ranged between 53% for acute diarrhoea and 92% for upper respiratory tract infections. Amoxicillin was the most dispensed antibiotic across all case scenarios. Over 50% of dispensed antibiotics were done upon recommendation of the drug dispensers in the absence of a doctor's prescription. Furthermore, for all the dispensed antibiotics across all case scenarios, no advice was given for finishing a full course of the antibiotics. Conclusion: This study found high rates of over-the-counter dispensing of antibiotics, which call for urgent and comprehensive regulatory measures to control antibiotic consumption in an urban part of Malawi that risks increased AMR. These could range from enacting stringent antibiotic dispensing policies to deploying digital systems to monitor prescription practices and community education on rational antibiotic use.
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