Laws need to be better enforced to stop chemists giving out antibiotics without prescription, potentially fuelling a rise in antibiotic-resistant diseases, new research has found.
The world’s first study to look at the impact of non-prescription supply of antibiotics in community pharmacies has highlighted the scale of the problem and led researchers to issue the warning.
Muhammad Hadi, De Montfort University Leicester (DMU) lecturer in Pharmacy Practice, was part of the team who worked on the study.
He said: “These findings should give a wakeup call to the national and international policy makers to design and implement policies to curtail non-prescription use of antibiotics.”
The study was led by Asa Auta, a lecturer in pharmacy practice at University of Central Lancashire, and also involved University of Central Lancashire, Queensland University of Technology, University Universities of of Edinburgh and University of, Leeds, along with Ahmadu Bello University, Nigeria, and the University of Maryland, USA.
The team searched global databases for studies published between 2000 and 2017 to find how often antibiotics had been sold by and supplied to community pharmacies in 24 countries around the world.
They found that between 2000 and 2010, the number of antibiotics used rose from 50 billion to 70 billion tablets. The highest increase of antibiotic use was recorded in Brazil, Russia, India, China and South Africa.
South America had the highest incidence of non-prescription supply of antibiotics in community pharmacies.
Globally, antibiotic resistance is responsible for more than two million infections.
Emmanual Adewuyi of the Queensland University of Technology, said: “Studies from 24 countries were analysed and to our alarm we discovered that antibiotics are frequently supplied without prescription in many countries. This use of antibiotics could facilitate the development and spread of antibiotic resistance.
He said of the 24 countries included in the study, only Thailand did not classify antibiotics as prescription only, yet the supply of antibiotics with a prescription was commonplace in all.
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Most of the antibiotics supplied without prescription were for short-term, limited illnesses such as stomach problems and upper respiratory tract infections.
He said: "Many were also broad-spectrum antibiotics like amoxicillin, azithromycin and others which increase the risk of the development of difficult-to-treat infections like the deadly methicillin resistant Staphylococcus aureus.
"Considering most countries have laws prohibiting over-the-counter sales of antibiotics, there is a need to ensure such laws are more strictly enforced where appropriate."
• The paper, Global Access to Antibiotics without Prescription in Community Pharmacies: a systematic review and meta-analysis, has just been published in The Journal of Infection.
Posted on Thursday 26th July 2018