Dispensing of antimicrobials in Kenya : a cross sectional pilot study and its implications

Mukokinya, Mwasi Mary Ann and Opanga, Sylvia and Oluka, Margaret and Godman, Brian (2018) Dispensing of antimicrobials in Kenya : a cross sectional pilot study and its implications. Journal of Research in Pharmacy Practice, 7 (2). pp. 77-82. ISSN 2279-042X (https://doi.org/10.4103/jrpp.JRPP_17_88)

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Objectives: Irrational use of antibiotics is a major driver of antimicrobial resistance, enhanced by inappropriate prescribing and dispensing of antibiotics. Little is currently known about dispensing of antibiotics in Kenya including self-medication with antibiotics. Consequently, the objective was to evaluate the extent of self-medication of antibiotics and dispensing practices in Kenya. Methods: Cross sectional study among 3 randomly selected community pharmacies in Nairobi. Findings: There was a low level of dispensing of antibiotics without a prescription with over ninety percent (94.1%) of antibiotics dispensed with a valid prescription. The most common antibiotics dispensed were the penicillins at just over fifty percent of all antibiotics, the cephalosporins at over twelve percent (12.6%) and the fluoroquinolones at just under twelve percent (11.7%). There were concerns with high use of third and fourth generation cephalosporins versus first and second generation as well as co-amoxiclav versus other penicillins. Encouragingly, antibiotics were not dispensed for influenza or a common cold, and generally very good dispensing processes, with typically a good level of medication history and counselling. Conclusion: Low levels of self-medication of antibiotics and high adherence to quality standards for dispensing are encouraging and provide direction to other countries. Educational initiatives are needed though to address high levels of co-amoxiclav prescribing.