BACKGROUND

Current regulations in Spain state that antibiotics cannot be sold without a medical prescription. The objective of this study was to quantify the percentage of pharmacies selling antibiotics without an official medical prescription in Catalonia, Spain, by the simulation of 3 different clinical cases presented by actors.

METHODS

A prospective study was performed from January through May 2008. Three different cases were presented at pharmacies: sore throat, acute bronchitis, and a urinary tract infection. Three levels of demand were used to convince the pharmacists to sell an antibiotic.

RESULTS

A total of 197 pharmacies were visited. Antibiotics were obtained from 55 (79.7%) of 69 pharmacies when a urinary tract infection was simulated, 24 (34.8%) of 69 pharmacies when a sore throat was simulated, and 10 (16.9%) of 59 pharmacies when acute bronchitis was simulated (P < .001). Among the pharmacies that sold antibiotics, the pharmacists provided an explanation as to the number of times per day the drug should be taken in 84.3%, explained the duration of treatment in 68.7%, and inquired about allergies prior to the sale of the antibiotic in only 16.9%. Of the 108 pharmacies that did not sell the antibiotics, only 57 (52.8%) explained that they could not be given over the counter for health care reasons or to avoid antibiotic resistance.

CONCLUSIONS

These results demonstrate that, although illegal, the sale of antibiotics without a prescription continues in Spain. This should be taken into account by countries that are currently considering the possibility of making some antibiotics available over the counter.