Antibiotic purchasing through online pharmacies: A mystery shopper study

Area of Science:

• Pharmaceutical Sciences
• Public Health
• Online Pharmacy Regulation

Background:

• The illegal sale of antibiotics via online pharmacies (OPs) presents significant public health risks.
• Ensuring drug quality, authenticity, and appropriate use is compromised by unregulated online sales.

Purpose of the Study:

• To investigate the prevalence and characteristics of illegal online antibiotic sales.
• To assess the extent of non-compliance with regulations by local and international OPs.

Main Methods:

• A mystery shopper study evaluated topical clindamycin, oral amoxicillin, and amoxicillin/clavulanic acid sales.
• Searches were conducted on Google, Bing, and Yahoo, examining the first 20 results from 60 identified OPs.
• Purchases were systematically made to determine prescription requirements and sales practices.

Main Results:

• Ten antibiotic products were successfully delivered from local OPs; international OPs often used suspicious payment methods like Bitcoin.
• 33.3% of OPs did not request prescriptions, with 45% of these being fake and selling topical clindamycin.
• While most OPs displayed contact details (96.7%) and return policies (85%), only 13.3% had quality certifications.

Conclusions:

• Stricter regulations and enhanced monitoring of OPs are urgently needed to combat illegal antibiotic sales.
• The study highlights significant non-compliance and risks associated with online antibiotic pharmacies, excluding dark web investigations.