Pharmaceutics and Pharmaceutical Technology Department, School of Pharmacy, The University of Jordan, Amman, Jordan.
Department of Pharmacy Practice, School of Pharmacy, Yarmouk University, Irbid, Jordan.
PLoS One. 2019 Apr 29;14(4):e0216115. doi: 10.1371/journal.pone.0216115. eCollection 2019.
It is well known that the emergence of antibiotic resistance is linked to the misuse and overuse of antibiotics. Misuse includes self-medication and the inappropriate use of antibiotics because of improper dosage or improper duration than recommended. This study investigated three patterns of dispensing antibiotics in a sample of community pharmacies in Jordan. This included dispensing antibiotics by prescription or over-the-counter either by direct request or upon a pharmacist's recommendation. The antibiotics dispensed were evaluated in terms of indication, appropriateness of dose, and duration of treatment based on the empirical treatment suggested by selected references: Lexicomp (2017) and UptoDate (2017) and the manufacturer's recommendations. Of the 457 antibiotics dispensed, almost one third were without prescription. Of the antibiotics dispensed with prescription or without prescription, 31.5% and 24.6% respectively were appropriate dosage and duration (p = 0.002). In the three patterns of dispensing, beta lactam antibiotics were the most commonly dispensed. In addition, it was noticed that there was a tendency to prescribe or dispense higher generations of antibiotics to cases that could have been treated with lower generation or safer antibiotics. Furthermore, 12.2% of the antibiotics were dispensed to treat infections that are not indicated for them. In conclusion, a significant proportion of antibiotics are dispensed without prescription in Jordan. Moreover, a considerable proportion of prescribed antibiotics were inappropriate for the conditions concerned. This indicates the importance of enforcing the Jordanian regulations prohibiting the dispensing of nonprescription antibiotics and the implementation of continuous education to physicians and pharmacists to increase awareness about the emergence of antibiotic resistance.
众所周知，抗生素耐药性的出现与抗生素的滥用和过度使用有关。滥用包括自行用药和因剂量不当或疗程超过推荐时间而不合理使用抗生素。本研究调查了约旦社区药店样本中三种抗生素配药模式。这包括根据处方或非处方配药，无论是直接要求还是根据药剂师的建议。根据选定参考文献（Lexicomp [2017] 和 UptoDate [2017]）和制造商的建议，根据经验治疗建议，评估所配抗生素的适应证、剂量和治疗持续时间。在配给的 457 种抗生素中，近三分之一没有处方。在有处方或无处方配给的抗生素中，分别有 31.5%和 24.6%的剂量和持续时间合适（p=0.002）。在三种配药模式中，β内酰胺类抗生素是最常配给的抗生素。此外，人们注意到有一种倾向，即给可能用较低代或更安全的抗生素治疗的病例开处方或配给更高代的抗生素。此外，12.2%的抗生素用于治疗不适合他们的感染。总之，在约旦，相当大比例的抗生素没有处方就配给了。此外，相当一部分处方抗生素不适用于相关情况。这表明有必要执行约旦禁止非处方抗生素配药的法规，并对医生和药剂师进行持续教育，以提高对抗生素耐药性出现的认识。
