Al-Ghamdi M S
Department of Pharmacology, King Faisal University, College of Medicine, PO Box 2114, Dammam 31451, Kingdom of Saudi Arabia.
Saudi Med J. 2001 Dec;22(12):1105-8.
It is a well known phenomenon in the Kingdom of Saudi Arabia that prescription drugs are dispensed over the counter in the community pharmacies. The aim of this study is to document the attitude of community pharmacists to fulfill the concept of pharmaceutical care and to evaluate how they manage a case of acute uncomplicated lower urinary tract infection.
Eighty-eight community pharmacists in the Eastern province of Saudi Arabia were presented with a patient claiming urinary tract infection and seeking medical treatment.
Only one attendant pharmacist refused to dispense medications without prescription. Fifteen others (17%) dispensed urinary antiseptic only and 72 (82%) gave antibacterial agents. Fluoroquinolones were the most commonly dispensed (69%) as first choice and 87% as an alternative) followed by co-trimoxazole, penicillins, cephalosporins and tetracyclines. The number of drugs dispensed ranged from a single agent at 52 (59%), 2 drugs at 31 (35%) and 3 drugs at 4 (4.5%) pharmacies. The average cost was Saudi Riyal (SR) 45.8 ($12.2) for first choice drugs and SR 31.5 ($ 8.4) for the alternatives.
The heavy dispensing of fluoroquinolones over the counter could eventually lead to increased resistance of the pathogenic bacteria to these drugs. However, despite the lack of pharmacist's adherence to the pharmaceutical law, this study does not indicate that they had abused their patients. It is rather demonstrating the urgent needs for successful implementation of the pharmaceutical law taking into consideration better integration between governmental health providers and the private retail pharmacies. In addition, it supports calls to educate pharmacists to perform basic clinical assessment in the community pharmacy, as a vital tool to effectively manage their patients' health status. The Ministry of health should credit such educational activity for the renewal of pharmacist's license in the Kingdom.
在沙特阿拉伯王国，处方药在社区药店非处方配药是一个众所周知的现象。本研究的目的是记录社区药剂师对实现药学服务理念的态度，并评估他们如何处理急性单纯性下尿路感染病例。
向沙特阿拉伯东部省份的88名社区药剂师展示了一名声称患有尿路感染并寻求治疗的患者。
只有一名值班药剂师拒绝无处方配药。另外15名（17%）仅配了尿路抗菌剂，72名（82%）给予了抗菌药物。氟喹诺酮类药物是最常作为首选配出的（69%），作为替代药物的占87%），其次是复方新诺明、青霉素、头孢菌素和四环素。配药数量在52家（59%）药店为单一药物，31家（35%）药店为两种药物，4家（4.5%）药店为三种药物。首选药物的平均费用为沙特里亚尔（SR）45.8（12.2美元），替代药物为SR 31.5（8.4美元）。
氟喹诺酮类药物在柜台大量配药最终可能导致病原菌对这些药物的耐药性增加。然而，尽管药剂师未遵守药品法，但本研究并未表明他们虐待了患者。这反而表明迫切需要成功实施药品法，同时考虑到政府卫生服务提供者与私人零售药店之间更好的整合。此外，它支持呼吁对药剂师进行教育，使其在社区药店进行基本临床评估，这是有效管理患者健康状况的重要工具。卫生部应认可此类教育活动，以用于沙特王国药剂师执照的更新。
