Evidence map›Paper›PMID 40486980›Full record

ArticleExploratory research in clinical and social pharmacy2025

Antibiotic dispensing practices in community pharmacies: Implications for antimicrobial stewardship in resource-constrained settings.

Abdullah Al Masud, Ramesh Lahiru Walpola, Malabika Sarker, Muhammad Asaduzzaman, Md Saiful Islam, Ayesha Tasnim Mostafa, Zubair Akhtar, Alamgir Kabir, Holly Seale

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Article in Exploratory research in clinical and social pharmacy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Abdullah Al MasudSchool of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Ramesh Lahiru WalpolaSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Malabika SarkerBrown School of Public Health, Brown University, USA.
Muhammad AsaduzzamanDepartment of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Md Saiful IslamSchool of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Ayesha Tasnim MostafaBRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Zubair AkhtarThe Kirby Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Alamgir KabirSchool of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Holly SealeSchool of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Over-the-counter antibiotic sales in community-pharmacies significantly drive antimicrobial resistance (AMR) in low- and middle-income countries (LMICs) due to inappropriate use and early treatment discontinuation. In Bangladesh, community pharmacies, which dispense 56.6 % of antibiotics without prescriptions, serve as the first health-seeking touchpoint, yet conventional stewardship strategies often overlook these informal providers, heightening AMR risks. This study examines drug-sellers' understanding and practices towards antibiotic dispensing and compares their symptomatic-treatment practices with Bangladesh's Standard Treatment Guidelines (STGs) to understand the extent of antibiotic misuse. Methods: A cross-sectional survey in two urban and two rural areas of Bangladesh involved 120 drug-sellers from 30 randomly selected pharmacies per site. Knowledge was compared between drug-sellers with pharmacy-dispensing training and those without training, and their suggested treatments for two simulated health-symptoms-upper respiratory-tract and gastrointestinal infections-were evaluated against STGs to determine the extent of misuse. Results: Most drug-sellers were aged 41-50 years (35.0 %), with 39.2 % holding a bachelor's degree or higher, and 65.8 % having pharmacy-dispensing training. The overall knowledge score on antibiotic use and AMR was moderate at 60.2 % (5-7 out of 10), with 32.5 % scoring ≤4, indicating poor knowledge; trained drug-sellers scored significantly better ( Conclusion: This study highlights the need for context-specific policies and regulatory measures in informal healthcare settings. While improving drug-sellers' knowledge is vital for antimicrobial stewardship in LMICs like Bangladesh, it alone is insufficient due to market competition, weak regulation, and patient-driven demand. Thus, curbing inappropriate antibiotic use at the community level requires stronger enforcement and multifaceted, context-tailored interventions-including public awareness, targeted training, and market-responsive strategies.

Indexed as

Antibiotic dispensingAntimicrobial resistance (AMR)Community pharmaciesOver-the-counter antibioticsStandard treatment guidelines (STGs)Symptomatic-treatment practices

Identifiers

PMID40486980
PMCPMC12142531

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.