High prevalence of antibiotic purchase without prescription in community pharmacies in Bucaramanga, Colombia.

Objectives: Self-medication is a key driver of antimicrobial resistance, and despite regulatory restrictions in Colombia, nonprescription antibiotic sales remain a significant public health concern. This study aimed to describe the purchase of antibiotics without a prescription in community pharmacies located in neighborhoods of Bucaramanga, Colombia, and to identify associated factors. Methods: Cross-sectional study. We included adult customers of community pharmacies in Bucaramanga (10 neighborhoods), who purchased antibiotics between November 1, 2024, and April 30, 2025. The 19-item survey included purchase of antibiotics with or without a prescription as the dependent variable, and sociodemographic characteristics, antibiotic recipient characteristics, and purchased antibiotic profile as independent variables. Statistical analysis was performed using Stata 18.0. Results: A total of 428 participants were included, with a mean age of 37.3 ± 14.3 years; 53.3% were women and 70.8% belonged to a middle socioeconomic level. The prevalence of purchasing antibiotics without a prescription was high (90.7%), particularly for amoxicillin (36.2%) and azithromycin (20.8%). Regular self-medication was more frequent among participants who purchased antibiotics without a prescription (54.6%) than among those who did so with a prescription (10%). Conclusion: The purchase of antibiotics without a prescription was highly prevalent, and self-medication was a common practice. These findings highlight deficiencies in regulatory enforcement and health education.