Sale of antibiotics without a prescription at community pharmacies in urban China: a multicentre cross-sectional survey
Sale of antibiotics without a prescription at community pharmacies in urban China: a multicentre cross-sectional survey
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DOI：
10.1093/jac/dkw519
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发表时间：
2017-04-01
影响因子：
5.2
通讯作者：
Fang, Yu
中科院分区：
文献类型：
--
作者：
Chang, Jie;Ye, Dan;Fang, Yu
目的：量化无处方抗生素的销售情况，评价我国城市社区药房抗菌药物销售质量。方法：采用模拟客户法，于2015年对社区药房进行多中心横断面调查。分别在南京东部、长沙中部和西安中国西部的社区药房进行了儿童腹泻和成人急性上呼吸道感染两种临床病例情景的系统抽样。结果：在2 56家药房中，模拟儿童腹泻和模拟成人呼吸道感染时，无处方获得抗生素的比例分别为55.9%(95%CI：49.5%~62.0%)和77.7%(95%CI：72.1%~82.7%)。在提供抗生素的药房中，83.9%和66.3%的药店是在模拟客户要求或坚持的情况下发放抗生素的，如儿童腹泻和成人呼吸道感染。不同城市间抗生素使用不当的比例差异有统计学意义(P<；0.001，x(2)检验)，南京、长沙和西安的儿童腹泻和成人呼吸道感染的比例分别为57.7%、37.3%和73.7%和60.8%、80.7%和96.1%。只有14.8%(95%可信区间：10.7%-19.8%)的药房有药剂师。结论：中国市区社区药房在没有处方的情况下，抗生素很容易获得。有必要采取措施，加强执行仅限处方的条例和药房工作人员的培训方案，以促进抗生素的适当使用。
Objectives: To quantify sales of antibiotics without a medical prescription and to assess the quality of pharmacy services in relation to the antibiotics sold in community pharmacies in urban China.Methods: A multicentre cross-sectional survey of community pharmacies was undertaken in 2015 using the simulated client method. Two clinical case scenarios (paediatric diarrhoea and adult acute upper respiratory infection) were presented at systematically sampled community pharmacies in Eastern (Nanjing), Central (Changsha) and Western China (Xi'an).Results: Of 256 pharmacies, antibiotics were obtained without a prescription from 55.9% (95% CI: 49.5%-62.0%) when paediatric diarrhoea was simulated and from 77.7% (95% CI: 72.1%-82.7%) when adult respiratory infection was simulated. Of the pharmacies where antibiotics were dispensed, 83.9% and 66.3% dispensed after the simulated clients requested or insisted in the case of paediatric diarrhoea and adult respiratory infection, respectively. Significant differences (P < 0.001, chi(2) test) in inappropriate antibiotic dispensing were found among cities, with 57.7%, 37.3% and 73.7% in the case of paediatric diarrhoea and 60.8%, 80.7% and 96.1% in adult respiratory infection in Nanjing, Changsha and Xi'an, respectively. Pharmacists were available in only 14.8% (95% CI: 10.7%-19.8%) of the pharmacies. The performance of pharmacy staff regarding the provision of information and advice was unsatisfactory.Conclusions: Antibiotics were easily obtained without a prescription in community pharmacies in urban China. Measures to enhance the enforcement of prescription-only regulations and training programmes for pharmacy staff to promote the appropriate use of antibiotics are warranted.