title: Determinants of antibiotic dispensing without a medical prescription: a cross-sectional study in the north of Spain.
abstract: OBJECTIVE
  Antibiotic resistance is a major public health concern and is greatly exacerbated by inappropriate antibiotic use at a community level. The aim of this study was to ascertain which attitudes of community pharmacists were related to inappropriate antibiotic dispensing.
  
  
  METHODS
  We conducted a cross-sectional study of community pharmacists in a region situated in northern Spain (n = 393). Personal interviews were conducted using a self-administered questionnaire. The degree of agreement with each item of knowledge and attitude was measured using an unnumbered, horizontal visual analogue scale, with replies being scored from 0 (total disagreement) to 10 (total agreement). The data were analysed using logistic regression.
  
  
  RESULTS
  Of the total of 286 pharmacists (72.8%) who completed the questionnaire, 185 (64.7%) acknowledged having undertaken dispensing of antibiotics without a medical prescription (DAwMP). Attitudes such as patient complacency, external responsibility, indifference and insufficient knowledge were shown to be related to DAwMP. In contrast, no association was found with any of the pharmacists' personal or professional traits.
  
  
  CONCLUSIONS
  This study confirms that, albeit unlawful, DAwMP is a common practice in Spanish pharmacies. DAwMP was seen to be usually associated with some of the attitudes evaluated.
authors: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors: Maruxa
authors: M
authors: Zapata-Cachafeiro
authors: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors: Cristian
authors: C
authors: González-González
authors: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors: Juan M
authors: JM
authors: Váquez-Lago
authors: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain Galician Ministry of Health, Galicia, Spain.
authors: Paula
authors: P
authors: López-Vázquez
authors: Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors: Ana
authors: A
authors: López-Durán
authors: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Santiago de Compostela, Spain.
authors: Ernesto
authors: E
authors: Smyth
authors: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Santiago de Compostela, Spain adolfo.figueiras@usc.es.
authors: Adolfo
authors: A
authors: Figueiras
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003157:Community Pharmacy Services / Q000639:trends*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010595:Pharmacists / Q000639:trends*; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic usage; antimicrobial resistance; pharmacists