title: Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania.
abstract: BACKGROUND
  Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs) in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs), in Tanzania.
  
  
  METHODS
  This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice.
  
  
  RESULTS
  As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004). The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg, antibiotic sale without prescription and no referral made, for complicated cases, ADDOs performed worse than DLDBs. As many as 30% of DLDBs and 35% of ADDOs dispensed incomplete doses of antibiotics. In both ADDOs and DLDBs, fortified procaine penicillin powder was dispensed as topical application for injuries.
  
  
  CONCLUSIONS
  There was no statistical difference between ADDOs and DLDBs in the violation of dispensing practice and both ADDOs and DLDBs expressed poor knowledge of the basic pharmacology of antibiotics.
authors: Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors: Om
authors: O
authors: Minzi
authors: Vs
authors: V
authors: Manyilizu
keywords: accredited drug-dispensing outlets; antibiotic-dispensing practice; duka la dawa baridi
references: J Acad Hosp Adm. 1995 Jan;7(1):19-22
references: 10154802
references: J Antimicrob Chemother. 2006 Aug;58(2):320-6
references: 16735428
references: Trop Med Int Health. 2002 Oct;7(10):878-85
references: 12358624
references: Int J Pharm Pract. 2011 Feb;19(1):30-5
references: 21235657
references: N Engl J Med. 1997 Aug 14;337(7):441-6
references: 9250845
references: World J Urol. 1999 Dec;17(6):372-82
references: 10654368
references: Health Policy Plan. 2000 Dec;15(4):357-67
references: 11124238
references: J Antimicrob Chemother. 2002 Aug;50(2):241-7
references: 12161405
references: Health Policy Plan. 2007 Nov;22(6):393-403
references: 17921151
references: Niger J Clin Pract. 2012 Apr-Jun;15(2):151-5
references: 22718162
references: Soc Sci Med. 1996 Apr;42(8):1155-61
references: 8737433
references: PLoS One. 2012;7(1):e30196
references: 22291918
references: Trop Geogr Med. 1988 Apr;40(2):166-70
references: 3407009
references: Bull World Health Organ. 1980;58(5):747-51
references: 6975183
references: Soc Sci Med. 2001 Feb;52(3):393-404
references: 11330774
references: Ann Pharmacother. 2004 Oct;38(10):1675-82
references: 15340128
references: Am J Trop Med Hyg. 1988 Nov;39(5):484-90
references: 3195696
references: Soc Sci Med. 1991;33(1):83-9
references: 1882245
references: Lancet Infect Dis. 2005 Aug;5(8):481-93
references: 16048717
references: East Mediterr Health J. 2007 Sep-Oct;13(5):1202-11
references: 18290415
references: Sex Transm Infect. 2000 Aug;76(4):299-302
references: 11026888
references: BMJ. 1998 Sep 5;317(7159):637-42
references: 9727992
references: J Clin Pharm Ther. 2008 Dec;33(6):625-34
references: 19138240
references: J Med Assoc Thai. 2006 Nov;89 Suppl 5:S125-32
references: 17718253
references: Niger Postgrad Med J. 2006 Sep;13(3):220-4
references: 17066110