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根据准入、观察、储备(AWaRe)分类法的药店抗生素配药模式:巴基斯坦不同地区新冠疫情浪潮后的多中心研究

Pattern of antibiotic dispensing at pharmacies according to access, watch, reserve (AWaRe) classification: multicenter study after COVID-19 waves in different districts of Pakistan.

作者信息

Khan Faiz Ullah, Khan Farman Ullah, Sajjad Aqsa, Ahmad Tawseef, Mallhi Tauqeer Hussain, Ali Sayyad, Ullah Kamran Hidayat, Shah Shahid

机构信息

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China.

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.

出版信息

BMC Res Notes. 2025 Jan 27;18(1):38. doi: 10.1186/s13104-024-07030-0.

Abstract

OBJECTIVE

The dispensing of non-prescription antibiotics is a worldwide concern, and antibiotics should only be dispensed with a legitimate prescription.

METHODOLOGY

A cross-sectional study was conducted using the simulated client methodology, with data collected, recorded, and analyzed using SPSS.

RESULTS

The simulated client visited 210 pharmacies, of which 70 dispensed antibiotics without a prescription. Outcomes The most often suggested antibiotics for upper respiratory tract infections (URTIs) were Amoxicillin (n = 17, 8.1%), Clarithromycin (n = 20, 9.5%), and Moxifloxacin (n = 13, 6.2%), with 33.3% of medications dispensed without a prescription for URTIs. Cefixime (n = 20, 9.5%) and ceftriaxone (n = 17, 8.1%) were the most often administered medications for urinary tract infections (UTIs). The non-prescribed dispensing of upper respiratory tract infections (URTIs) and urinary tract infections (UTIs) was markedly elevated (p < 0.05). Antibiotics were dispensed without a prescription for diarrheal diseases in over 50% of pharmacies, with Metronidazole (n = 23, 11%), Azithromycin (n = 16, 7.6%), and Rifaximin (n = 15, 7.1%) being the most often prescribed. In all bivariate and multivariate models, male gender was associated with reduced likelihood (COR: 0.30, 95% CI: 0.12-0.72; p = 0.0079 and AOR: 0.03, 95% CI: 0.005-0.15; p = 0.0001). Individuals aged 30 years and older exhibited increased odds of dispensing in both bivariate (COR: 3.67, 95% CI: 1.69-8.87; p = 0.0018) and multivariate analyses (AOR: 9.44, 95% CI: 2.55-61.70; p = 0.001). The presence of a pharmacist on duty markedly diminished the likelihood of administering antibiotics without a prescription (COR: 0.13, 95% CI: 0.06-0.25; p = < 0.001; AOR: 0.06, 95% CI: 0.03-0.16; p = < 0.001).

CONCLUSION

These findings highlight the imperative of enforcing existing laws and implementing rigorous rules, alongside pharmacy-centered antimicrobial stewardship programs that focus on accurate dispensing practices to mitigate antimicrobial resistance.

摘要

目的

非处方抗生素的配药是一个全球性问题,抗生素仅应凭合法处方配药。

方法

采用模拟顾客法进行横断面研究,使用SPSS收集、记录和分析数据。

结果

模拟顾客走访了210家药店,其中70家无处方配出了抗生素。结果上呼吸道感染(URTI)最常被推荐的抗生素是阿莫西林(n = 17,8.1%)、克拉霉素(n = 20,9.5%)和莫西沙星(n = 13,6.2%),33.3%的上呼吸道感染药物是无处方配出的。头孢克肟(n = 20,9.5%)和头孢曲松(n = 17,8.1%)是尿路感染(UTI)最常使用的药物。上呼吸道感染和尿路感染的无处方配药情况显著增加(p < 0.05)。超过50%的药店无处方配出治疗腹泻疾病的抗生素,最常被处方的是甲硝唑(n = 23,11%)、阿奇霉素(n = 16,7.6%)和利福昔明(n = 15,7.1%)。在所有双变量和多变量模型中,男性配药可能性降低(校正比值比:0.30,95%置信区间:0.12 - 0.72;p = 0.0079;调整后比值比:0.03,95%置信区间:0.005 - 0.15;p = 0.0001)。30岁及以上个体在双变量(校正比值比:3.67,95%置信区间:1.69 - 8.87;p = 0.0018)和多变量分析(调整后比值比:9.44,95%置信区间:2.55 - 61.70;p = 0.001)中配药几率增加。有值班药剂师显著降低了无处方配出抗生素的可能性(校正比值比:0.13,95%置信区间:0.06 - 0.25;p = < 0.001;调整后比值比:0.06,95%置信区间:0.03 - 0.16;p = < 0.001)。

结论

这些发现凸显了执行现有法律、实施严格规定以及开展以药店为中心的抗菌药物管理计划的必要性,该计划侧重于准确配药做法以减轻抗菌药物耐药性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76ba/11773753/c82a6b4d7784/13104_2024_7030_Fig1_HTML.jpg

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