ArticleJournal of pharmaceutical policy and practice2026
A point prevalence survey on antibiotic dispensing practices identifies targets for quality improvement of antimicrobial stewardship in community pharmacies in Dar es Salaam, Tanzania.
Article in Journal of pharmaceutical policy and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Inappropriate antibiotic use is a major driver of antimicrobial resistance (AMR), especially in low- and middle-income countries (LMICs), where over-the-counter antibiotics are readily available without a prescription. This study assessed antibiotic dispensing practices in community pharmacies in Dar es Salaam, Tanzania. Methodology: From February to March 2025, a point prevalence survey was conducted in 100 community pharmacies in Dar es Salaam. Researchers approached existing customers, obtained consent, and conducted confidential interviews. Five participants were enrolled per pharmacy, for a total of 500 participants. Results: Overall, 64% (320/500) of community pharmacy attendees were dispensed antibiotics, of whom 71% (227/320) received them without a prescription. Access-group antibiotics were most frequently dispensed (56%, 201/356), followed by Watch (32%, 115/356) and Reserve groups (3%, 10/356), with metronidazole (15%, 53/356) and azithromycin (12%, 44/356) being the most commonly dispensed antibiotics. Urinary tract infection (UTI) was the leading indication (37%, 119/320), mainly treated with azithromycin (25%, 35/138), ciprofloxacin (12%, 16/138), and nitrofurantoin (7%, 9/138). Among antibiotic recipients, 44% (140/320) received antibiotics based on dispensers' recommendations. Ceftriaxone was commonly dispensed with prescriptions, while all Reserve antibiotics were dispensed without prescriptions. Participants with technical/vocational education (adjusted prevalence ratio [aPR], 1.38, 95% CI: 1.13-1.68, Conclusion: Most clients attending community pharmacies in Dar es Salaam receive antibiotics without prescriptions, often based on dispensers' recommendations. The widespread use of Watch and Reserve antibiotics without oversight highlights major regulatory gaps and the urgent need for stronger policy enforcement and antimicrobial stewardship.
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