Assessing Antibiotic Dispensing Practices for Viral Infections in Community and Hospital Pharmacies: A Simulated Client Study

Abstract

Background  

Antibiotic misuse, particularly for viral infections, was a major global health issue that contributed significantly to antimicrobial resistance (AMR). Pharmacies played a crucial role in medication dispensing, but inappropriate practices worsened the problem. This study investigated antibiotic dispensing practices for viral infections in community and hospital pharmacies across the Mirpur, Bhimber, and Kotli districts of Azad Jammu & Kashmir (AJK), Pakistan.

Objectives of Study

This study aimed to evaluate community and hospital pharmacies' practices regarding the dispensing of antibiotics for viral infections and to assess pharmacy personnel’s knowledge of the effectiveness of antibiotics against viral infections.

Methodology

A descriptive cross-sectional study design was used. A simulated client approach was employed, in which we, as researchers, visited pharmacies to assess the dispensing practices of pharmacy personnel regarding viral infections. This method provided a realistic evaluation of service quality and compliance with antibiotics dispensing regulations for viral infections. Direct interviews with dispensing personnel were conducted, and responses were recorded in a pre-designed questionnaire to maintain the confidentiality of the data. Data were collected from 226 community and hospital pharmacies. Percentages and frequencies were calculated using SPSS version 20.

Results

The results indicated significant gaps in adherence to proper dispensing practices. 99.6% of pharmacies dispensed antibiotics for viral infections, with Azithromycin being the most frequently dispensed (38.9%). Only 46.9% of pharmacies requested a prescription before dispensing antibiotics, while 78.8% failed to inquire about the client’s medical history. Alarmingly, 95.1% of pharmacy personnel believed that antibiotics are effective against viral infections. Overall, 90.7% of the dispensing practices were rated as poor. Influenza (17.7%) and the common cold (16.8%) were the most frequently encountered conditions.

Conclusion

This study highlighted the widespread inappropriate dispensing of antibiotics for viral infections in pharmacies across three districts of AJK. The findings underscored an urgent need for stricter prescription policies, pharmacist training, and public awareness campaigns to reduce antibiotic misuse and combat AMR.