Purchasing and consumption of over-the-counter antibiotics:a mixed-method approach to secondary data

This research explores the reasons for antibiotic purchasing and consumption at retail pharmacies in rural China. Although an increasing amount of policy recommendations are put forward, empirical studies are still lacking on antibiotic purchasing over the counter and consumption of over the counter (OTC) antibiotics in China. My research addresses this evidence gap.Firstly, a quantitative analysis was conducted on the structured observations data from the mixed-method research project Pathways to optimising antibiotic use in rural China: identifying key determinants in community and clinical settings ‘Antibiotic Pathways study’. The aim was to investigate the prevalence of OTC antibiotics dispensing and consumption and the characteristics of medical encounters in retail pharmacies. Secondly, I conducted a qualitative analysis of in-depth interviews from the same research project. The aim was to explore the purchasing and consumption of antibiotics from retail pharmacies and to provide an in-depth exploration of customers’ experience of OTC antibiotic consumption.The findings suggest that local access to antibiotics for residents remains prevalent, as a result of the lack of restrictions on purchasing antibiotics without prescription at the lower levels of the healthcare system. Customers’ perception of the ’convenient’ purchase of antibiotics over the counter, short medical encounters and easy access in the retail sector, and policy implementation contributed to the prevalent purchasing and consumption of over-the-counter antibiotics.This study provides additional support for policy recommendations on antibiotic stewardship in the retail sector. The findings suggest that addressing antibiotic stewardship in lower levels of the healthcare system requires a focus on policy implementation, and the variability of healthcare resources across regions should be taken into consideration to ensure the effective implementation of antibiotic stewardship in China