Antimicrobial dispensing process in community pharmacies: a scoping review

Area of Science:

• Public Health
• Pharmacy Practice
• Infectious Diseases

Background:

• Antimicrobial resistance is a significant global health threat.
• Community pharmacy antimicrobial dispensing is crucial for mitigating resistance.
• Existing research overlooks interventions in antimicrobial dispensing services.

Purpose of the Study:

• To determine the antimicrobial dispensing process in community pharmacies.
• To identify common practices and interventions during antimicrobial dispensing.
• To highlight areas for improvement in pharmacy-based antimicrobial stewardship.

Main Methods:

• A comprehensive scoping review was conducted in September 2020.
• Searches were performed across five major databases (PubMed, EMBASE, LILACS, Web of Science, Cochrane).
• Data from 35 included studies were extracted and descriptively analyzed.

Main Results:

• Most studies (63%) were from Asia, predominantly using cross-sectional designs (n=27).
• Antimicrobial dispensing without prescription was common (89%), assessed mainly via simulated patients (n=22).
• Pharmacist questioning focused on allergies and symptoms; counseling covered side effects, precautions, and usage, with referrals also noted.

Conclusions:

• Antimicrobial dispensing processes are mainly studied in low- and middle-income countries, often involving dispensing without prescriptions.
• Pharmacists exhibit minimal questioning and counseling during dispensing, indicating practice deficiencies.
• Multifaceted strategies are needed to reduce antimicrobial misuse and combat resistance, making process evaluation fundamental.