Dispensing of antibiotics without prescription in community drug retail outlets of Bahir Dar city in Northwest Ethiopia: A simulated client visit before and after educational intervention

Non-prescription supply of antibiotics in community drug retail outlets (CDROs) significantly contributes to antibiotic resistance (ABR). This study aimed to assess the effectiveness of educational intervention for pharmacy practitioners (PPs) in reducing over-the-counter (OTC) antibiotic sales. From August 1, 2022 to January 30, 2023 a total of 80 simulated client (SC) visits (40 pre-intervention; 40:post-intervention) were made in 40 CDROs of Bahir Dar city, to determine the baseline and post-intervention extent of OTC sale of antibiotics. Verbally a 30 minute one time onsite education regarding antimicrobials, antibiotics, ABR, rational use of antibiotics, role of community PPs in ensuring rational use of antibiotics, and good antibiotic dispensing practice (GADP) as an intervention was provided to 70 PPs who were working in the 40 CDROs. The education was guided with a written informational material which was delivered to each PPs. Two months after the intervention, its effectiveness was tested using McNemar's chi-square test and P-value < 0.05 was considered statistically significant. The intervention resulted significant improvements in; reducing non-prescription sale of antibiotics in CDROs (55% (pre-intervention) Vs 20% (post-intervention), increasing requesting of a prescription paper (35% Vs 75%), insisting antibiotic must be dispensed with prescription paper (33.3% Vs 68.7%) and reducing dispensing of antibiotic at level 1 demand (50% Vs 25%). Educational intervention provided to PPs was effective in reducing the non-prescription sale of antibiotics and it improves the antibiotic dispensing practice.