Over-the-counter sales of high-priority antibiotics are common: results of a global survey

Background Antimicrobial resistance (AMR) is a critical public health threat exacerbated by the sales of antibiotics without prescriptions. Despite national action plans, data on global over-the-counter (OTC) availability remains limited. Methods We surveyed members of the AMR Insights Ambassador Network across 37 countries using a web-based instrument. Data analysis was conducted by the survey programme and verified by two authors (X.Y. and N.M.M.). Results Despite regulations, 65% of respondents reported antibiotics were available OTC in their countries. Pharmacies were the primary source (85.9%), followed by internet vendors (23.4%). Notably, carbapenems and glycopeptides were reported to be available without prescriptions by 36.7% and 26.7% of respondents, respectively. Conclusions These findings highlight a significant gap between policy and practice. The availability of high-priority antimicrobials without prescriptions demands urgent regulatory enforcement and improved surveillance of both physical pharmacies and digital marketplaces.