title: Self-medication with antibiotics in the Republic of Srpska community pharmacies: pharmacy staff behavior.
abstract: OBJECTIVE
  Self-medication with antibiotics adds to the global risk of increased spread of bacterial resistance. Attitudes and behavior of health professionals also may reinforce self-medication with antibiotics. The aim of this study was to determine whether self-medication with antibiotics is possible in our community pharmacies and to what extent, and to evaluate the behavior and service of pharmacy health professionals regarding non-prescription antibiotic dispensation.
  
  
  METHODS
  An observational, cross-section study was conducted, and pseudo-patient methodology was used to establish the kind of professional service provided in case of patient's explicit demand to buy an antibiotic for treatment of self-diagnosed upper respiratory tract infection.
  
  
  RESULTS
  Of the total 318 community pharmacies, 131 (41%) were visited and included in the study. Non-prescription antibiotics were dispensed in 76 (58%) pharmacies. Counseling and symptomatic therapy was offered in 88 (67%) pharmacies. In 25% of pharmacies, no symptomatic therapy was offered; instead, only an antibiotic was sold. Amoxicillin was sold in 85% of cases and, mostly, the one of 1.30 Euro per pack. Both oral and written use instructions were given in 78% cases, whereas none was given in 3% of cases.
  
  
  CONCLUSIONS
  Self-medication with antibiotics occurs in our community pharmacies, despite being illegal. Pharmacy staff behavior can be a factor that puts patients at risk for self-medication with antibiotics. Community pharmacies are failing their tasks in enhancing rational use of antibiotics. Such a practice may be a consequence of weak enforcement and control over the legislation and professional standards.
authors.affiliation: Ministry of Health and Social Welfare, the Republic of Srpska, Bosnia and Herzegovina. v.mpekovic@mzsz.vladars.net
authors.forename: Vanda
authors.initials: V
authors.lastname: Marković-Peković
authors.forename: Nataša
authors.initials: N
authors.lastname: Grubiša
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D001519:Behavior; D017522:Bosnia and Herzegovina; D003430:Cross-Sectional Studies; D006801:Humans; D010594:Pharmacies / Q000941:ethics*; D010595:Pharmacists / Q000941:ethics*; D063487:Prescription Drug Misuse; D012651:Self Medication / Q000941:ethics / Q000706:statistics & numerical data*
chemical_list: D000900:Anti-Bacterial Agents