Antibiotic dispensation by Lebanese pharmacists: A comparison of higher and lower socio-economic levels

Summary: Introduction: Indiscriminate use of antibiotics contributes to a global spread of antimicrobial resistance. Previous studies showed an excessive consumption of antibiotics purchased without medical prescription from community pharmacies, mainly in developing countries.There is a shortage of studies revealing the role of community pharmacists in the overuse of antibiotics. Our objective is to study the dispensing policy of non-medical prescription antibiotics in community pharmacies, assessing the possible influence of the socio-economic level of the area over this practice. Methods: A cross-sectional study was conducted between February and May 2011 among 100 pharmacists working in Beirut's pharmacies and its suburbs. Pharmacies were divided into 2 groups according to the socio-economic level of the population living in the pharmacy area. A self-administered questionnaire was filled by pharmacists. Results: Over-the-counter antibiotic availability existed in both higher and lower socio-economic areas: on the whole, 32% of antibiotics were dispensed without medical prescription, with higher frequency in lower socio-economic areas (p = 0.003). Dispensing injectable antibiotics without medical prescription was significantly higher in lower socio-economic areas (p = 0.021), as well as dispensing an association of 2 antibiotics without medical prescription (p = 0.001). Pharmacists working in lower socio-economic areas recommended more frequent antibiotics to children and the elderly (p < 0.001 and p = 0.004, respectively). Conclusion: Dispensing antibiotics without medical prescription in Beirut community pharmacies is a common practice, particularly in lower socioeconomic areas. This public health problem should be addressed at the social, educational, and legislative levels. Keywords: Dispensing antibiotics, Community pharmacist, Medical prescription, Socio-economic level, Lebano