埃塞俄比亚亚的斯亚贝巴社区药房抗生素非处方销售情况探究：药剂专业人员视角
Exploration of over the counter sales of antibiotics in community pharmacies of Addis Ababa, Ethiopia: pharmacy professionals' perspective.
作者信息
Gebretekle Gebremedhin Beedemariam, Serbessa Mirgissa Kaba
机构信息
School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
School of Public Health, College of Health Sciences, Addis Ababa University, P .O. Box: 1176, Addis Ababa, Ethiopia.
出版信息
Antimicrob Resist Infect Control. 2016 Jan 29;5:2. doi: 10.1186/s13756-016-0101-z. eCollection 2016.
BACKGROUND
Over the counter sale of antibiotics is a global problem and it is increasingly recognized as a source of antibiotic misuse and is believed to increase treatment costs, adverse effects of treatment and emergence of resistance. The increasing trend of over the counter sale of antibiotics in Ethiopia calls for exploration of why such dispensing is practiced. This study aims to explore reasons for over the counter sale of antibiotics in the community pharmacies of Addis Ababa, Ethiopia.
METHODS
A phenomenological qualitative study was conducted in five randomly selected community pharmacies of Addis Ababa. One pharmacy professional from each pharmacy were interviewed at the spot using semi-structured, open-ended interview checklist. Besides, observation of professionals' dispensing practice was made for at least one hour in the same community pharmacies using an observation checklist. Findings were categorized into specific themes that were developed following the objectives. This was facilitated by use of OpenCode 3.6 software.
RESULTS
All participants pointed out that antibiotics were frequently dispensed without prescription and contend that the trend of such dispensing has been increasing. The findings indicated that the nonprescription sales of antibiotics were common for Amoxicillin, Ciprofloxacin and Cotrimoxazole. The poor, less educated and younger groups of the population were reported to frequently request antibiotics without prescription. The main reasons for nonprescription sale of antibiotics by pharmacy professionals were found to be related to pharmacy owner's influence to maximize revenue, customer's pressure, weak regulatory mechanism and professional conflicts of interest.
CONCLUSION
The study shows that nonprescription sale of antibiotics was common practice at least in Addis Ababa. The main reasons for this malpractice were the need to maximize revenue and weak regulatory mechanism. Hence, strong regulatory enforcement and community awareness campaign is called for to limit nonprescription sale of antibiotics.
背景
抗生素非处方销售是一个全球性问题，越来越被视为抗生素滥用的一个源头，并且被认为会增加治疗成本、治疗的不良反应以及耐药性的出现。埃塞俄比亚抗生素非处方销售的增长趋势促使人们探究为何会有这种配药行为。本研究旨在探究埃塞俄比亚亚的斯亚贝巴社区药房抗生素非处方销售的原因。
方法
在亚的斯亚贝巴随机选取的五家社区药房开展了一项现象学定性研究。使用半结构化、开放式访谈清单对每家药房的一名药学专业人员进行现场访谈。此外，使用观察清单在同一社区药房对专业人员的配药行为进行至少一小时的观察。研究结果被归类为根据研究目标形成的特定主题。这借助OpenCode 3.6软件得以实现。
结果
所有参与者均指出抗生素经常在无处方的情况下被配出，并认为这种配药趋势一直在增加。研究结果表明，阿莫西林、环丙沙星和复方新诺明的抗生素非处方销售很常见。据报告，贫困、受教育程度较低和较年轻的人群经常无处方索要抗生素。发现药房专业人员抗生素非处方销售的主要原因与药房老板为实现收入最大化的影响、顾客压力、监管机制薄弱以及职业利益冲突有关。
结论
该研究表明，至少在亚的斯亚贝巴，抗生素非处方销售是常见现象。这种不当行为的主要原因是实现收入最大化的需求和监管机制薄弱。因此，需要加强监管执法并开展社区宣传活动以限制抗生素非处方销售。
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