A study on the sale of antimicrobial agents without prescriptions in pharmacies in an urban area in south India

Introduction: Antimicrobial drug resistance is a fast emerging problem worldwide. It is a consequence of the use, particularly of the misuse of drugs. In most of the developing countries, antibiotics can be purchased without prescriptions, even when the practice is not legal. Presently, in India, Schedule H, under the Drug and Cosmetics Act and Rules, provides a list of over 536 drugs which include Antimicrobial Agents [AMAs], which are required to be sold on the prescription of a registered medical practitioner. Objectives: To evaluate the Over the Counter (OTC) sales of antimicrobial agents in allopathic pharmacies [community] within the city corporation limits. To describe the degree of difficulty which is faced in obtaining antibiotics without a prescription. To find out as to what advice, if any, was given by the pharmacists with regards to the administration of the medicines which had been sold. Methods: Three diseases were simulated by two medical students who presented as patients in randomly selected pharmacies at an Urban location. They then requested the pharmacists for medications for their illnesses. AMAs were requested for, if they were not issued at the first instance. Results and Discussion: Nearly 50% of the pharmacists declined to issue AMAs. Amoxicillin was the most common of the AMAs which were dispensed by the pharmacists. The duration and the frequency of the treatment which was advised by the pharmacists were mostly wrong. Conclusion: This study showed that the practice of dispensing AMAs without prescriptions was widely prevalent among the dispensaries which were located even in urban areas. Not only were the AMAs dispensed, but also they were dispensed without taking any history of hypersensitivity. What makes the practice worse is that the duration and the frequency of administration of these drugs are wrongly advised more often than not.