School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, United Kingdom.
Leicester School of Pharmacy, De Montfort University, Hawthorn Building, Leicester LE1 9BH, United Kingdom.
J Infect. 2019 Jan;78(1):8-18. doi: 10.1016/j.jinf.2018.07.001. Epub 2018 Jul 5.
To estimate the proportion of over-the-counter antibiotic requests or consultations that resulted in non-prescription supply of antibiotics in community pharmacies globally.
We systematically searched EMBASE, Medline and CINAHL databases for studies published from January 2000 to September 2017 reporting the frequency of non-prescription sale and supply of antibiotics in community pharmacies across the world. Additional articles were identified by checking reference lists and a Google Scholar search. A random effects meta-analysis was conducted to calculate pooled estimates of non-prescription supply of antibiotics.
Of the 3302 articles identified, 38 studies from 24 countries met the inclusion criteria and were included in the review. All the included countries with the exception of one, classified antibiotics as prescription-only medicines. The overall pooled proportion of non-prescription supply of antibiotics was 62% (95% CI 53-72). The pooled proportion of non-prescription supply of antibiotics following a patient request was 78% (95% CI 59-97) and based on community pharmacy staff recommendation was 58% (95% CI 48-68). The regional supply of non-prescription antibiotics was highest in South America, 78% (95% CI 72-84). Antibiotics were commonly supplied without a prescription to patients with symptoms of urinary tract infections (68%, 95% CI 42-93) and upper respiratory tract infections (67%, 95% CI 55-79). Fluoroquinolones and Penicillins respectively were the most commonly supplied antibiotic classes for these indications.
Antibiotics are frequently supplied without prescription in many countries. This overuse of antibiotics could facilitate the development and spread of antibiotic resistance.
估计全球社区药店中非处方抗生素请求或咨询中导致非处方供应抗生素的比例。
我们系统地检索了 EMBASE、Medline 和 CINAHL 数据库，以查找 2000 年 1 月至 2017 年 9 月期间发表的报告全球社区药店中非处方药销售和供应抗生素频率的研究。通过检查参考文献和 Google Scholar 搜索，确定了其他文章。采用随机效应荟萃分析计算抗生素非处方供应的汇总估计值。
在 3302 篇文章中，有 38 项来自 24 个国家的研究符合纳入标准并被纳入综述。除一个国家外，所有纳入的国家均将抗生素归类为处方药。抗生素非处方供应的总体汇总比例为 62%（95%CI 53-72）。根据患者要求供应非处方抗生素的汇总比例为 78%（95%CI 59-97），根据社区药店工作人员建议供应的比例为 58%（95%CI 48-68）。南美的非处方抗生素供应比例最高，为 78%（95%CI 72-84）。抗生素通常未经处方就供应给有尿路感染（68%，95%CI 42-93）和上呼吸道感染（67%，95%CI 55-79）症状的患者。氟喹诺酮类和青霉素类分别是这两种适应症最常供应的抗生素类别。
在许多国家，抗生素经常未经处方供应。这种抗生素的过度使用可能会促进抗生素耐药性的发展和传播。
