Assessment of Dispensing Practice of Antibiotics in the Selected Community Pharmacies: A Prospective Study

Introduction: Dispensing is the provision of drugs as set out correctly on a lawful prescription by the pharmacist/Healthcare professional doctor. The over-the-counter sale of antibiotics is a global problem. Antibiotics are very commonly prescribed and dispensed for patients in pharmacies, and it is increasingly recognized as antibiotic misuse. This misuse may increase the treatment cost and the development of antimicrobial resistance. Therefore, an assessment of dispensing patterns of antibiotics is essential to know the standard of pharmacy practice and prevent unnecessary antimicrobial resistance.

Objectives: To categorize the class of antibiotics used in the various diseases, check for the appropriateness of the antibiotics observed in the prescription, and understand the pattern of dispensing of antibiotics.

Methods: A community-based- a cross-sectional observational study was carried out for six months in Selected community pharmacies in Kumaraswamy Layout, Kengeri Bengaluru, Gubbi Tumkur District, Ballari Karnataka, SrikalahastiAndhra Pradesh. Document The information collected in the data collection form. PIL has been distributed to the study subjects. The data were analyzed using descriptive analysis.

Results: Among 26 pharmacy visits and 538 cases, 393(73%) were dispensed by D pharm graduates, 63(11.7%) BA graduates. 355(66%) were administered with a prescription, and 183 (34%) were dispensed without a prescription. The highly distributed brand was Spectratil (cefpodoxime) 46 (8.6%), Macrobid (Nitrofurantoin) 26(4.8%), Mahacef (cefixime) 24(4.4%) and Augmentin (Amoxycilin+Clavalunate) 18(3.4%), and the least dispensed brand was Q max (Ofloxacin) 1(0.2%), OFM (Ofloxacillin+Metrinidazole) 1(0/2%). Most of the antibiotics administered were for cough and fever i.e. 222 (41.3%) and toothache 85 (15.8%). Study subjects who had not heard about antibiotics were 461(85.7%), and 77(14.3) knew about antibiotics. 308(57.2%) said they could stop antibiotics after completing the course, and 193(35.9%) said antibiotics could be stopped when the patient felt better. Among 26 pharmacy visits, 440(81.8%) agreed that pharmacists should not dispense antibiotics without a valid prescription, and 344(64.9%) dispense antibiotics both by self-knowledge and request by the patient. 532(98.9%) know about schedule H1, and 512(95.2%) follow the Schedule H1 act. Among 538 study subjects, 406(75.5%) accepted the Patient information leaflet (PIL), whereas 122(22.7%) denied the PIL, and 10(1.9%) pharmacists did not permit us to distribute PIL.

Conclusion: The antibiotic class is majorly prescribed/dispensed as cephalosporins. 80 % of the registered pharmacists were presented in the community pharmacy dispensing activity. The legality of the prescription was 32%. Antibiotic appropriateness use must promotion by the community pharmacist is essential, so they must educate them. Physicians should charge minimal consultation fees, reduce the count of patients approaching the pharmacy without a prescription. In addition, continuous education to physicians and pharmacists to increase awareness about the emergence of antibiotic resistance plays a vital role in the society for proper use of antibiotics.