Dispensing of antibiotics without a medical prescription and communication skills of pharmacists.

Consumption of antibiotics leads to emergence and selection of antimicrobial-resistant bacterial strains which have become a problem in most countries. Despite the fact that antibiotics are considered as prescription-only medicines, these drugs are often requested by and dispensed to patients without a medical prescription in many areas of the world. Despite being illegal, over-the-counter sales of antibiotics still occurs in Spain. The supply of an antibiotic from a pharmacy without a prescription involves a consultation with a pharmacist. From our experience, having good communication skills can help pharmacists to convince patients about the need for not taking some drugs customers ask for. However, research focusing on this aspect is lacking. A prospective study was performed in 2008 in a randomised sample of pharmacies in Catalonia. Antibiotics were obtained without a medical prescription in 45.2% of the pharmacies surveyed. This study aimed to determine whether pharmacists who sell antibiotics without a prescription have different communication skills from those who refuse to sell them. The methodology of the study has been described elsewhere. Two actors presented three different cases (sore throat, acute bronchitis, and urinary tract infection) in a sample of 197 pharmacies and asked pharmacists for an antibiotic without a medical prescription. In case that pharmacists refused to sell them the actors collected information about the type of reasons given. A response was considered administrative if the reason given only referred to the regulations or law in that, without a prescription the antibiotic could not be sold. A health-related point of view or comprehensive reason involved the response that it is not good for your health to sell you this medication or antibiotics cannot be given for viral infections or that selling an antibiotic in this case could lead to the spread of drug resistance. The specific skills check-off list evaluated by the simulated patients consisted of nine items, described in table 1, with Table 1 List of the communication skills evaluated by simulated patients.