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Community pharmacists perspectives about reasons behind antibiotics dispensing without prescription: a qualitative study

Mansour A Mahmoud, Mohammed Aldhaeefi, Aziz Sheikh, Hisham Aljadhey

Background: Dispensing of antibiotics without prescription is a widespread practice particularly in developing countries. This may lead to bacterial resistance, extra cost and possible adverse drug events.

Objective: To explore views, experiences and perceptions of community pharmacists about the reasons behind antibiotics dispensing without prescription.

Methods: This was a qualitative enquiry conducted among community pharmacists working in Riyadh city, Saudi Arabia. Interviews were conducted with the pharmacists using a semi structured interview guide. All interviews were audio-recorded, transcribed verbatim and then coded and analysed independently by two researchers.

Results: A total of 16 community pharmacists were interviewed. The majority of the pharmacists have dispensed antibiotics without prescription during their practice (14 out of 16). Indications for dispensing antibiotics included fever, sore throat, tonsillitis, urinary tract infections, common cold and cough. Factors contributing to the dispensing of antibiotics without prescriptions included, increasing demand by the public, financial considerations, promotion by pharmaceutical companies, the pharmacy management and time pressures. However, pharmacists mentioned that they did not dispense antibiotics without prescriptions for severe cases and patients with unknown or incomplete medical history.

Conclusion: Pharmacists reported several encouraging factors to dispense antibiotics without prescription. A combination of public education, professional training and enforcing regulations are likely to be important in ensuring patient safety and appropriate dispensing and use of antibiotics.