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Antibiotic dispensing without a prescription is common in Sri Lanka, with 61% of pharmacies complying. While a pharmacist

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Area of Science:

  • Pharmacology and Pharmacy Practice
  • Public Health and Epidemiology

Background:

  • Dispensing antibiotics without a prescription is illegal in Sri Lanka but prevalent.
  • This study quantifies the extent of this practice for the first time.

Purpose of the Study:

  • To assess community pharmacy staff responses to requests for antibiotics without a prescription.
  • To identify factors influencing the dispensing of antibiotics without a prescription.

Main Methods:

  • A cross-sectional simulated client study involving 242 community pharmacies.
  • Trained simulated clients requested specific antibiotics without a prescription.
  • Data collected on pharmacy staff interactions and dispensing practices.

Main Results:

  • 61% of pharmacies dispensed antibiotics without a prescription.
  • Ciprofloxacin was the most frequently dispensed (70%), amoxicillin the least (52%).
  • Pharmacist presence reduced dispensing without prescription (Adj. OR=0.54) but did not improve history taking.

Conclusions:

  • Widespread dispensing of antibiotics without prescription in Sri Lankan community pharmacies.
  • Pharmacy staff rarely inquired about patient history or advised seeking medical consultation.
  • Pharmacist presence may mitigate but not eliminate inappropriate dispensing.