Antibiotic Dispensing Practices in Community Pharmacies: A Major Health Concern in the Eastern Democratic Republic of Congo

Aims: The practice of antibiotic dispensing in community pharmacies may contribute to irrational use of antibiotics. The aim of this study was to evaluate the antibiotic dispensing patterns in community pharmacies of the Eastern DRCongo.

Methods: It is a cross-sectional study carried out at Bukavu city. The study included 1504 subjects attending community pharmacies. Thus, a total number of 40 pharmacies were selected. The sociodemographic profiles of patients and dispensers were also recorded. The pharmacological interventions were investigated in terms of antibiotics dispensed according to patient’s complaints, antibiotic dispensing with or without prescription, the substitution of antibiotics in prescriptions.

Results: Participants attending pharmacies for antibiotic needs were in the mean age of 29.8±13 years. Most of the pharmacy workers consisted of pharmacy technicians (70%) and no trained dispensers (20%). Pharmacists represented only 10% of all dispensers in community pharmacies. We found that 67.8% of subjects purchased antibiotics without prescription. The antibiotics dispensed without prescription were either on patients’ requests (70.1%) or the suggestion of dispensers (29.9%). Only 18.4% of prescriptions were subject to substitution. The conditions for requiring antibiotic dispensing without prescriptions were respectively gastrointestinal (34%), respiratory (27%), genitourinary (25%), skin (11%) and dental (2%) infections. Conditions that were not well defined represented 1%. In cephalosporins, Cefixime was the most important drug dispensed without prescription (72.5%) whereas in penicillins, this was Amoxicillin (55.5%). Doxycycline was more dispensed in the class of cyclines (69.4%). Erythromycin (53.1%) and Azithromycin (29.4%) were more dispensed in the class of macrolides. Ciprofloxacin was the most dispensed drug in the class of quinolones (74.3%) and Metronidazole (86.8%) in the class of imidazoles.

Conclusion: The Antibiotic dispensing practice is very critical in the community pharmacies of Bukavu city due to the lack of qualified dispensers. This may increase the antibiotic self-medication and contribute to antibiotic resistance.