[Antibiotics dispensed upon the recommendation of staff in private dispensaries in Abidjan in the Ivory Coast].
BACKGROUND
The inappropriate dispensing of antibiotics and inadequate antibiotic treatment leads to the emergence of bacterial resistance. The aim of this study is to assess and describe the antibiotics dispensed upon the recommendation of staff in private pharmacies in Abidjan. It is also a matter of determining whether the information given when the drug is dispensed encourages the correct compliance of the antibiotic treatment by the patients.


METHODS
Eighteen private pharmacies were in these private pharmacies was recorded using observation handbooks. Focus groups were set up with staff from the private pharmacies with the aim of better understanding of the actions observed. In the study, only antibiotics administered in systemic way were taken into account.


RESULTS
One thousand one hundred and twenty-three purchases of antibiotics were observed in total, 158 of which were dispensed upon the recommendation of staff in the private pharmacies (14.1%) [95% CI = 12.1-16.3%]. Penicillin, co-trimoxazole and macrolides constituted the most frequently recommended groups of antibiotics. Compared with the assistants, the pharmacists recommended antibiotics more frequently to customers. The three main groups of symptoms leading to the dispensing of antibiotics upon recommendation were respiratory, gastro-intestinal and cutaneous symptoms. The staff in private pharmacies almost systematically recommended antibiotics for loose coughs lasting more than three days without taking into account the customer's age, general condition and extra-respiratory signs. The duration of the antibiotic treatment was clearly given in 25 cases (15.8%) and information telling customers to take antibiotics at mealtimes was only given on exceptional occasions. It transpired from the meetings conducted with pharmacy staff that there were indirect financial incentives, known as "Unités Gratuites", offered by the medical reps from certain pharmaceutical laboratories, encouraging the excessive dispensing of antibiotics.


CONCLUSIONS
The staff in private pharmacies in Abidjan advise customers to take antibiotics even though they are prescription-only drugs. This leads to the inappropriate dispensing of antibiotics. Some information essential for the correct compliance of the treatment by patients, such as the duration of the treatment and taking it at mealtimes, are often omitted. Educational interventions aimed at pharmacy staff and measures encouraging the application of the law on the sale of antibiotics, are necessary to improve the dispensing of these drugs in private pharmacies in Abidjan.
Hounsa
A
A
Service de Microbiologie Médicale du Centre Hospitalier Universitaire de Liège, Université de Liège, Belgique. hounsa20003@yahoo.fr
De Mol
P
P
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D007560:Cote d'Ivoire; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010594:Pharmacies / Q000458:organization & administration*; D010595:Pharmacists; D010596:Pharmacy Technicians; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents