Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India

Miraj, Sonal Sekhar and Saravu, Kavitha and Pai, Madhukar (2019) Over-the-counter antibiotic dispensing by pharmacies: a standardised patient study in Udupi district, India. BMJ Global Health, 4 (6). pp. 1-9. ISSN 2059-7908

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Background: Antimicrobial resistance is a global health emergency, and one of the contributing factors is overuse and misuse of antibiotics. India is one of the world’s largest consumers of antibiotics, and inappropriate use is potentially widespread. This study aimed to use standardised patients (SPs) to measure over-the-counter antibiotic dispensing in one region. Methods: Three adults from the local community in Udupi, India, were recruited and trained as SPs. Three conditions, in both adults and children, were considered: diarrhoea, upper respiratory tract infection and acute fever. Adult SPs were used as proxies for the paediatric cases. Results: A total of 1522 SP interactions were successfully completed from 279 pharmacies. The proportion of SP interactions resulting in the provision of an antibiotic was 4.34% (95% CI 3.04% to 6.08%) for adult SPs and 2.89% (95% CI 1.8% to 4.4%) for child SPs. In the model, referral to another provider was associated with an OR 0.38 (95% CI 0.18 to 0.79), the number of questions asked was associated with an OR 1.54 (95% CI 1.30 to 1.84) and an SP–pharmacist interaction lasting longer than 3 min was associated with an OR 3.03 (95% CI 1.11 to 8.27) as compared with an interaction lasting less than 1 min. Conclusion: Over-the- counter antibiotic dispensing rate was low in Udupi district and substantially lower than previously published SP studies in other regions of India. Dispensing was lowest when pharmacies referred to a doctor, and higher when pharmacies asked more questions or spent more time with clients.

Item Type: Article
Subjects: Departments at MU > Public Health
Pharmacy > MCOPS Manipal > Pharmacy Practice
Depositing User: KMC Library
Date Deposited: 12 Feb 2020 04:36
Last Modified: 12 Feb 2020 04:36
URI: http://eprints.manipal.edu/id/eprint/154869

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