School of Pharmacy, Haramaya University, Harar, Ethiopia
School of Public Health, Haramaya University, Harar, Ethiopia.
BMJ Open. 2024 Aug 28;14(8):e085352. doi: 10.1136/bmjopen-2024-085352.
Antibiotic misuse includes using them to treat colds and influenza, obtaining them without a prescription, not finishing the prescribed course and sharing them with others. Although drug providers are well positioned to advise clients on proper stewardship practices, antibiotic misuse continues to rise in Ethiopia. It necessitates an understanding of why drug providers failed to limit such risky behaviours. This study aimed to explore drug providers' perspectives on antibiotic misuse practices in eastern Ethiopia.
The study was conducted in rural Haramaya district and Harar town, eastern Ethiopia.
An exploratory qualitative study was undertaken between March and June 2023, among the 15 drug providers. In-depth interviews were conducted using pilot-tested, semistructured questions. The interviews were transcribed verbatim, translated into English and analysed thematically. The analyses considered the entire dataset and field notes.
The study identified self-medication pressures, non-prescribed dispensing motives, insufficient regulatory functions and a lack of specific antibiotic use policy as the key contributors to antibiotic misuse. We found previous usage experience, a desire to avoid extra costs and a lack of essential diagnostics and antibiotics in public institutions as the key drivers of non-prescribed antibiotic access from private drug suppliers. Non-prescribed antibiotic dispensing in pharmacies was driven by client satisfaction, financial gain, business survival and market competition from informal sellers. Antibiotic misuse in the setting has also been linked to traditional and ineffective dispensing audits, inadequate regulatory oversights and policy gaps.
This study highlights profits and oversimplified access to antibiotics as the main motivations for their misuse. It also identifies the traditional antibiotic dispensing audit as an inefficient regulatory operation. Hence, enforcing specific antibiotic usage policy guidance that entails an automated practice audit, a responsible office and insurance coverage for persons with financial limitations can help optimise antibiotic use while reducing resistance consequences.
抗生素滥用包括用抗生素治疗感冒和流感、未经处方获取抗生素、未完成规定疗程以及与他人共享抗生素。尽管药品供应商处于向客户提供适当管理实践建议的有利位置，但抗生素滥用在埃塞俄比亚仍持续上升。这需要了解药品供应商为何未能限制此类危险行为。本研究旨在探讨东部埃塞俄比亚药品供应商对抗生素滥用行为的看法。
该研究在东部哈勒尔地区的农村哈勒尔镇和哈勒尔镇进行。
2023 年 3 月至 6 月期间，进行了一项探索性定性研究，参与者为 15 名药品供应商。采用经过试点测试的半结构化问题进行深入访谈。访谈逐字记录，翻译成英文，并进行主题分析。分析考虑了整个数据集和实地笔记。
该研究确定自我医疗压力、非处方配药动机、监管功能不足以及缺乏特定的抗生素使用政策是抗生素滥用的主要原因。我们发现，以往的使用经验、避免额外费用的愿望以及公共机构缺乏基本诊断和抗生素是从私人药品供应商获得非处方抗生素的主要驱动因素。药店中非处方配药的驱动因素是客户满意度、经济利益、企业生存和来自非正规卖家的市场竞争。该环境中的抗生素滥用还与传统和无效的配药审计、监管监督不足和政策差距有关。
本研究强调了利润和获取抗生素的简单化是滥用的主要动机。它还确定了传统的抗生素配药审计是一种低效的监管操作。因此，实施特定的抗生素使用政策指导，包括自动化实践审计、负责的办公室和为有经济限制的人提供保险，可以帮助优化抗生素的使用，同时减少耐药后果。
