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BackgroundSelling antibiotics without prescriptions is mostly illegal worldwide, including in Ghana, and promotes antimicrobial resistance. We evaluated the prevalence and practice of selling antibiotics without prescriptions among community pharmacies (CPs) and drug outlets, for the first time, in Ghana to quantify and characterize this issue to inform future interventions.Research design and methodsTwo scenarios utilizing the Simulated Client Methodology were enacted: an upper respiratory tract infection of viral origin (scenario one); and pediatric diarrhea (scenario two). CPs/Outlets were selected by stratified proportional random sampling from four metropolitan cities (~14% of the total Ghanaian population). Selling of antibiotics was assessed at three demand levels and its overall prevalence was estimated, then stratified by the study variables.ResultsOut of the 265 sampled CPs/outlets, the prevalence of selling antibiotic without prescription was 88.3% (n = 234/265), with variations not only across the four regions [92.5% (n = 123/133) in Kumasi, 87.5% (n = 14/16) in Cape Coast, 84.1% (n = 69/82) in Accra, and 82.4% (n = 28/34) in Tamale] but also across CPs [90% (n = 121/134)] and drug outlets [86% (n = 113/131)].ConclusionsA very high prevalence/sub-optimal practice of selling antibiotics without prescriptions was found. This highlights the need to increase compliance with antibiotic dispensing legislation through evidence-based interventions including education of key stakeholders.

Original publication

DOI

10.1080/14787210.2023.2283037

Type

Journal article

Journal

Expert review of anti-infective therapy

Publication Date

07/2023

Volume

21

Pages

1373 - 1382

Addresses

Oral and Maxillofacial Surgery, Research Unit, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana.

Keywords

Humans, Diarrhea, Anti-Bacterial Agents, Child, Pharmacies, Ghana, Drug Prescriptions, Prescriptions