The quality of drugs in private pharmacies in Lao PDR: a repeat study in 1997 and 1999.
OBJECTIVE
To present a repeated test of the quality of ampicillin, tetracycline, chloroquine and ASA from private pharmacies in Laos in 1997 and 1999, and to discuss the quality in relation to the National Drug Policy Programme.


METHODS
A total of 115 of 214 licensed private pharmacies were selected in Savannakhet province, a pilot province in the Lao National Drug Policy Programme. The four drugs, if available, were collected at each pharmacy. Thirty tablets of each drug were taken from a selected container. In 1997, 366 samples were analysed and three hundred in 1999. Identity, assay (content of active component) and measurement of weight variation tests were performed. Drug quality was compared mainly according to the standards of the British and United States' pharmacopoeias.


RESULTS
The percentage of substandard drugs decreased significantly from 46% to 22% between 1997 and 1999 (P< 0.001). Substandard ampicillin and tetracycline were reduced significantly from 67% to 9% and from 38% to 12%, respectively (P < 0.001). In total, 3% vs 1% contained no active ingredient, 12% vs 4% had too little or too much active ingredient, and 35% vs 14% had weight variation outside pharmacopoeial limits.


CONCLUSIONS
Drug quality was improved. However, the prevalence of substandard drugs was still unacceptably high, which may result in adverse clinical effect or treatment failure for individual patients.
Syhakhang
Lamphone
L
Food and Drug Department, Ministry of Health, Vientiane, Lao PDR, and Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, 171 76 Stockholm, Sweden. Lamphone.Syhakhang@phs.ki.se
Lundborg
Cecilia Stålsby
CS
Lindgren
Björn
B
Tomson
Göran
G
D000667:Ampicillin / Q000592:standards; D000900:Anti-Bacterial Agents / Q000592:standards; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000592:standards; D000962:Antimalarials / Q000592:standards; D001241:Aspirin / Q000592:standards; D002214:Capsules; D002738:Chloroquine / Q000592:standards; D007812:Laos; D004364:Pharmaceutical Preparations / Q000592:standards*; D010593:Pharmaceutical Services / Q000592:standards*; D010602:Pharmacopoeias as Topic / Q000592:standards; D017149:Private Sector; D011785:Quality Assurance, Health Care; D011786:Quality Control; D013607:Tablets; D013752:Tetracycline / Q000592:standards
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000962:Antimalarials; D002214:Capsules; D004364:Pharmaceutical Preparations; D013607:Tablets; D000667:Ampicillin; D002738:Chloroquine; D013752:Tetracycline; D001241:Aspirin