Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis.
Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis.
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撒哈拉以南非洲国家社区药品零售点中抗生素制剂的非处方配药：系统回顾和荟萃分析。
DOI：
10.1186/s13756-020-00880-w
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发表时间：
2021-01-14
影响因子：
5.5
通讯作者：
Selvey LA
中科院分区：
文献类型：
--
作者：
Belachew SA;Hall L;Selvey LA
抗菌素耐药性的发展是全球最大的公共卫生挑战之一，其部分原因是在卫生保健中过度使用和/或误用抗生素。在撒哈拉以南非洲（SSA）国家，社区药品零售网点（cdro）的非处方抗生素分配已被标记为社区广泛滥用抗生素的促成因素之一。本综述旨在估计SSA地区CDROs因非处方抗生素请求或咨询导致无有效处方提供抗生素的比例，并描述所分配的抗生素类型。使用PubMed、CINAHL、Scopus和b谷歌Scholar进行文献检索。我们还检索了相关文献的参考文献列表。采用随机效应模型进行meta分析，确定抗生素非处方销售的汇总比例。采用亚组和元回归来探讨研究间效应大小异质性的潜在原因。在检索到的671个引文中，23个符合纳入标准（7个基于问卷的横断面调查和16个基于客户的横断面研究）。非处方抗生素请求或咨询导致无处方抗生素供应的总合并比例为69% （95% CI 58-80）。上呼吸道感染和/或急性腹泻是最常见的病例，阿莫西林和复方新诺明是治疗这些症状最常用的抗生素。发现抗生素的非处方配药是几个SSA国家cdro的常见做法。易于获得和过度使用抗生素可能会加速该区域现有抗生素耐药性的出现。我们的综述强调需要严格执行现有政策和/或制定新的监管框架来规范抗生素供应，并对药学人员（如药剂师、药学助理）进行关于明智使用抗生素和抗菌药物管理重要性的培训和教育支持。
The development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community. The current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed. A literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies. Of 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58–80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms. Non-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.
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影响因子：
1.1
作者：
Ampaire L;Muhindo A;Orikiriza P;Mwanga-Amumpaire J;Bebell L;Boum Y
通讯作者：
Boum Y
DOI：
10.2147/dhps.s106948
发表时间：
2016
期刊：
Drug, healthcare and patient safety
影响因子：
--
作者：
Erku DA;Mekuria AB;Surur AS;Gebresillassie BM
通讯作者：
Gebresillassie BM
影响因子：
2.2
作者：
Ayalew, Mohammed Biset
通讯作者：
Ayalew, Mohammed Biset
影响因子：
5.2
作者：
BERIH, AA;MCINTYRE, L;LYNK, AD
通讯作者：
LYNK, AD
影响因子：
1.6
作者：
Chokshi, Aastha;Sifri, Ziad;Horng, Helen
通讯作者：
Horng, Helen