Obtaining antibiotics online from within the UK: a cross-sectional study
Obtaining antibiotics online from within the UK: a cross-sectional study
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DOI：
10.1093/jac/dkx003
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发表时间：
2017-05-01
影响因子：
5.2
通讯作者：
Holmes, Alison Helen
中科院分区：
文献类型：
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作者：
Boyd, Sara Elizabeth;Moore, Luke Stephen Prockter;Holmes, Alison Helen
背景：改善抗生素管理（AS）并减少初级保健处方，同时个人互联网使用量的增加，可能会导致公民从网上的替代来源获得抗生素。 目标：进行横断面分析，以：（i）确定向英国公众销售抗生素的在线药店的质量和合法性； (ii) 描述从英国境内在线获取抗生素的流程； (iii) 确定由此产生的 AS 和患者安全问题。方法：使用 Google 和 Yahoo 搜索“在线购买抗生素”。对于每个搜索引擎，都会审查来自具有唯一 URL 地址的前 10 个网站的数据。对适当的药房注册、处方要求、抗生素选择是“处方者驱动”还是“消费者驱动”以及购买前是否需要（过敏、合并症、怀孕）或提供（不良反应）特定信息的证据进行了分析。 结果：详细分析了 20 个唯一的 URL 地址。证明其位于英国的在线药店（n = 5；25%）在购买抗生素之前需要处方，并进行了适当注册。不清楚其经营地点的在线药店（n = 10；50%）的处方要求各不相同，并且没有适当注册的证据。九家 (45%) 在线药店在购买前不需要处方。对于 16 家 (80%) 在线药店来说，抗生素选择、剂量和数量的决策最初是由消费者驱动的。结论：在线药店在抗生素实践方面存在很大差异，突出显示了相当大的患者安全和 AS 问题。在线抗生素供应商迫切需要改进教育、立法、监管和新的最佳实践管理指南。
Background: Improved antibiotic stewardship (AS) and reduced prescribing in primary care, with a parallel increase in personal internet use, could lead citizens to obtain antibiotics from alternative sources online.Objectives: A cross-sectional analysis was performed to: (i) determine the quality and legality of online pharmacies selling antibiotics to the UK public; (ii) describe processes for obtaining antibiotics online from within the UK; and (iii) identify resulting AS and patient safety issues.Methods: Searches were conducted for 'buy antibiotics online' using Google and Yahoo. For each search engine, data from the first 10 web sites with unique URL addresses were reviewed. Analysis was conducted on evidence of appropriate pharmacy registration, prescription requirement, whether antibiotic choice was 'prescriber-driven' or 'consumer-driven', and whether specific information was required (allergies, comorbidities, pregnancy) or given (adverse effects) prior to purchase.Results: Twenty unique URL addresses were analysed in detail. Online pharmacies evidencing their location in the UK (n = 5; 25%) required a prescription before antibiotic purchase, and were appropriately registered. Online pharmacies unclear about the location they were operating from (n = 10; 50%) had variable prescription requirements, and no evidence of appropriate registration. Nine (45%) online pharmacies did not require a prescription prior to purchase. For 16 (80%) online pharmacies, decisions were initially consumer-driven for antibiotic choice, dose and quantity.Conclusions: Wide variation exists among online pharmacies in relation to antibiotic practices, highlighting considerable patient safety and AS issues. Improved education, legislation, regulation and new best practice stewardship guidelines are urgently needed for online antibiotic suppliers.