Community pharmacists’ management of self-limiting infections: a simulation study in Akwa Ibom State, South-South Nigeria|
Akpan, Richard Mary; Udoh, Emmanuel Imo; Akpan, Samuel Emediong & Ozuluoha, Chioma Cynthia
Background: Inappropriate use of antibiotics, especially for treatment of self-limiting infections remains one of the major
drivers of antibiotic resistance (ABR). Community pharmacists can contribute to reducing ABR by ensuring antibiotics are
dispensed only when necessary.
Objective: To assess community pharmacists’ management of self-limiting infections.
Methods: A purposive sample of 75 pharmacies participated in the study. Each pharmacy was visited by an investigator
and a trained simulated patient who mimicked symptoms of common cold and acute diarrhoea, respectively. Interactions
between the simulated patient and pharmacist were recorded by the investigator in a data collection form after each visit.
Descriptive statistical analysis was carried out. Ethics approval was obtained from the state Ministry of Health Research
Results: For common cold, 68% (51/75) of pharmacists recommended an antibiotic. Azithromycin, amoxicillin/clavulanic
acid, and sulphamethoxazole/trimethoprim (43%, 24%, 20%, respectively) were the most frequently dispensed agents. For
acute diarrhoea, 72% (54/75) of pharmacists dispensed one antibiotic, while 15% dispensed more than one antibiotic. The
most frequently dispensed agent was metronidazole (82%), which was dispensed in addition to amoxicillin or tetracycline
among pharmacists who dispensed more than one agent. In both infection scenarios, advice on dispensed antibiotics was
ofered in 73% and 87% of the interactions, respectively.
Conclusion: This study shows high rate of inappropriate antibiotics dispensing among community pharmacists. There is
need for improved awareness of antibiotic resistance through continuing education and training of community pharmacists.
Furthermore, the inclusion of antibiotic resistance and stewardship in undergraduate pharmacy curriculum is needed.
Antibiotics; pharmacists; common cold; acute diarrhoea; community pharmacy; patient simulation.