title: Utilization of antimicrobial agents with and without prescription by out-patients in selected pharmacies in South-eastern Nigeria.
abstract: OBJECTIVE
  We conducted a study in out-patient pharmacies in South-eastern Nigeria in order to determine the extent of self-medication of antimicrobial agents in this area, assess the dosing error associated with this practice and to ascertain the extent of involvement of community pharmacies.
  
  
  METHODS
  A survey was carried out daily in selected community pharmacies for a period of 90 days. Data were collected on the number of patients visiting these shops for antimicrobial agents, the number getting their medication with a prescription, the number getting their order without prescription and on the type and dose of antimicrobial agents received. MAIN OUT-COME MEASURE: The percentage of patients with prescription and without prescription was compared. The percentage under-dosages or over-dosages associated with how each antimicrobial agent was obtained were compared. The total DDDs of antimicrobial agents dispensed within this period with and without prescription were compared.
  
  
  RESULTS
  A total of 4,128 outpatients visited the shops for antimicrobial agents within the period and were involved in the study. Of this number, 1,742 (42.2%) came with a prescription from qualified medical personnel and 2,386 (57.8%) came without a prescription. A total of 13,693.13 DDDs of antimicrobial agents was dispensed, of which 56.38% was dispensed with prescription and 43.62% was dispensed without prescription. The degrees of under-dosing were significantly (P < 0.05) higher in regimen filled without prescription when compared to those filled with prescription.
  
  
  CONCLUSIONS
  Majority of the patients in this region still obtains their antimicrobial agents without a proper prescription, which is associated with sub-therapeutic dosing of these agents. There is a need for better regulation of antimicrobial agents dispensing and utilization in the region.
authors.affiliation: Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria.
authors.forename: Charles Okey
authors.initials: CO
authors.lastname: Esimone
authors.forename: Chukwuemeka Sylvester
authors.initials: CS
authors.lastname: Nworu
authors.forename: Obinna Patrick
authors.initials: OP
authors.lastname: Udeogaranya
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions; D004363:Drug Utilization; D006801:Humans; D009549:Nigeria; D010045:Outpatients; D012651:Self Medication / Q000706:statistics & numerical data*
chemical_list: D000890:Anti-Infective Agents