Gladys Okafor Ukamaka, Gabriella Chukwujindu Nzube, Lawal Folasade Olufunke, Bukola Folorunso Oluwatoyin, Amaechi Victor Chikaodiri, Augustine Okoronkwo Ngozi
Department of Global Health and Bioethics, Euclid University, Bangui, Central African Republic.
Osun State Office, Pharmacy Council of Nigeria, Osogbo, Nigeria.
J Pharm Policy Pract. 2025 May 6;18(1):2498927. doi: 10.1080/20523211.2025.2498927. eCollection 2025.
Dispensing antibiotics without a prescription is common among community pharmacists in low- and middle-income countries despite its association with antibiotic resistance. This study describes the prevalence and nature of dispensing antibiotics without prescription among community pharmacists in Nigeria and its associated factors.
A cross-sectional study was conducted among community pharmacists in Nigeria with a validated, online, self-administered questionnaire. Reliability was assessed with Cronbach's alpha. Descriptive and inferential statistics were performed with SPSS Version 2023 at a 0.05% significance level.
A total of 420 community pharmacists participated in the study. The Reliability result was 0.860, implying the data collection tool's perfect internal consistency. Independent pharmacies represented 87.4% of the respondents, and most were in urban areas (71.4%). Most respondents (98.1%) dispensed antibiotics without prescription, with (84.2%) sometimes requesting laboratory investigations before dispensing antibiotics. Cephalosporin (74.8%), penicillin (70.2%), and quinolones (68.3%) were the major classes of antibiotics dispensed. The pharmacists' confidence in their clinical skills (78.8%), ability of the antibiotics to cover a broader range of microorganisms (78.0%), inability of patients to access healthcare services in other places (67.3%), emergencies (58.3%), affordability (49.0%), patients' demand (38.2%), absence of sanctions (34%), not getting prescriptions (33.1%), were the key deciding factors for the pharmacists to dispense antibiotics without prescription or substitute class of antibiotics. Factors like financial incentives, fear of losing clients, fear of expiry, competition from other pharmacies, and trust in patients' self-diagnosis were low in driving decisions to dispense antibiotics without prescriptions.
Non-prescription dispensing of antibiotics is high among community pharmacists in Nigeria, and is related to various factors. A strategic approach, including mandatory health insurance schemes, prescription and dispensing policies, and enforcement of antimicrobial stewardship regulations by the Nigerian government, is necessary to improve ethical practice and address the irrational dispensing and use of antibiotics in Nigeria.
在低收入和中等收入国家，社区药剂师无处方配发抗生素的情况很常见，尽管这与抗生素耐药性有关。本研究描述了尼日利亚社区药剂师无处方配发抗生素的流行情况、性质及其相关因素。
采用经过验证的在线自填式问卷对尼日利亚的社区药剂师进行横断面研究。使用克朗巴哈系数评估信度。使用SPSS 2023版本在0.05%的显著性水平上进行描述性和推断性统计。
共有420名社区药剂师参与了该研究。信度结果为0.860，这意味着数据收集工具具有完美的内部一致性。独立药店占受访者的87.4%，大多数位于城市地区（71.4%）。大多数受访者（98.1%）无处方配发抗生素，其中（84.2%）有时在配发抗生素前要求进行实验室检查。头孢菌素（74.8%）、青霉素（70.2%）和喹诺酮类（68.3%）是配发的主要抗生素类别。药剂师对其临床技能的信心（78.8%）、抗生素覆盖更广泛微生物的能力（78.0%）、患者在其他地方无法获得医疗服务（67.3%）、紧急情况（58.3%）、可负担性（49.0%）、患者需求（38.2%）、没有制裁措施（34%）、没有拿到处方（33.1%），是药剂师无处方配发抗生素或替代抗生素类别的关键决定因素。经济激励、担心失去客户、担心过期、来自其他药店的竞争以及对患者自我诊断的信任等因素在推动无处方配发抗生素决策方面的作用较低。
尼日利亚社区药剂师无处方配发抗生素的情况很普遍，且与多种因素有关。尼日利亚政府需要采取战略方法，包括强制推行医疗保险计划、处方和配药政策以及执行抗菌药物管理规定，以改善道德行为并解决尼日利亚抗生素的不合理配发和使用问题。
