Dispensing antibiotics without prescription at pharmacies: barriers and strategies for improvement.

Background: Antimicrobial resistance (AMR) is a worldwide public health challenge, and non-prudent use of antibiotics is one of key drivers of AMR. In some countries antibiotics are often sold without a prescription at pharmacies. In Armenia this problem is also observed despite national regulation. The objective of this work was to identify perception of pharmacy staff on main barriers for dispensing antibiotics with a prescription at community pharmacies and perceived strategies for improving the situation in Armenia. Methods: Survey was conducted at community pharmacies in different regions of Armenia. Pharmacists and pharmacy technicians were asked to complete pretested questionnaire. Data were analysed with SPSS statistical software. Results: Despite most of professionals reported that they are aware about regulation, 78.4% of 241 participants indicated that patients can buy antibiotics at their pharmacy without a prescription from doctor. Most of participants reported that the percentage of patients whom antibiotics were sold without a prescription is high. More than a half of responders indicated the following barriers for dispensing antibiotics with a prescription at community pharmacies: lack of patients’ awareness about effectiveness and safety of antibiotics (61.0%), difficulties for doctors to prescribe using approved forms (60.6%), poor prescribing practice (56.4%). More than a half of professionals consider that it is necessary to introduce the following strategies: organizing public awareness campaigns (68.0%), organizing special training courses for physicians and pharmacists (63.9%), introducing Medicines and therapeutic committees at health facilities (54.8%). Conclusions: Patients can buy antibiotics without a prescription at community pharmacies in Armenia. There are certain barriers for dispensing antibiotics with a prescription at community pharmacies. Educational and organizational strategies can be helpful for improving the situation. [ABSTRACT FROM AUTHOR]