Evaluation of community pharmacies regarding dispensing practices of antibiotics in two districts of central Nepal

OBJECTIVE To evaluate the status of community pharmacies, their staff, and practices toward dispensing antibiotics. DESIGN Cross-sectional, prospective. PLACE AND DURATION OF STUDY Community pharmacies in two districts of central Nepal, from March 2016 to May 2016. METHODS A systematic random sampling approach was adopted to sample 161 community pharmacies. Data on the registration status of pharmacies, qualification or training of dispensing staff, and the practice of dispensing antibiotics were collected using a pre-tested questionnaire. Face to face interviews were carried out by a previously trained interviewer. Data were analyzed for descriptive and inferential statistics using IBM SPSS Statistics 21. RESULTS Among 161 community pharmacies, 25% were not registered and most of them were located in rural areas. It was typical (66.5%) to dispense antibiotics without prescription and most (91.4%) of the staffs involved in dispensing were non-pharmacists. Furthermore, the study revealed common practices of replacing one brand of antibiotic with other brands (66%), dispensing incomplete courses of antibiotics (73%), and not giving any advice regarding antibiotic use (39%) or completion of a full course of therapy (80%). There were significant (p < 0.001) relationships between the location of pharmacies (rural vs urban) and the qualifications of the pharmacy staff. CONCLUSION Dispensing antibiotics without prescription and by non-pharmacists are common in this region. The study also found several issues regarding the irrational use of antibiotics. Thus, there is an urgent need to address these issues and promote the informed use of antibiotics.