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Antibiotic stewardship adherence inconsistent among online pharmacies
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In a recent survey, online pharmacies exhibited varying compliance with prescription regulations, including sale of antibiotics without a prescription, raising significant concerns regarding patient safety and antibiotic stewardship.
“Within the UK National Health Service, local antibiotic guidelines, a variety of hospital–based restrictive and persuasive interventions, community–based social norm feedback and national stewardship guidelines encourage judicious antibiotic prescribing,” Sara Elizabeth Boyd, MRCP, from Imperial College London, and colleagues wrote. “However, antibiotics may be acquired in much of the world without a prescription, despite this being illegal in many of the countries concerned. Within the UK, patient safety and current [antibiotic stewardship] strategies may be threatened due to antibiotics being available to purchase online, without a prescription, from a variety of vendors globally.”
Researchers conducted a cross-sectional analysis of online pharmacies to establish the quality and lawfulness of those who sell antibiotics. They also aimed to describe the steps one must go through to obtain antibiotics online and possible antibiotic stewardship (AS) and safety concerns.
The first 10 unique search results of “buy antibiotics online” on both Google and Yahoo search engines were analyzed. Areas of analysis included evidence of appropriate pharmacy registration, online pharmacies’ requirements for an antibiotic prescription, the influence of a medical professional on antibiotic choice, the influence of the consumer on antibiotic choice, and whether certain conditions required disclosure from the consumer (allergies, comorbidities, pregnancy) or the online provider (adverse side effects).
The online pharmacies that disclosed their location in the UK were registered correctly and required a prescription from a clinician before purchase; however, those without a clear geographical location varied in information required before purchase. None had appropriate registration for online pharmacies in the UK. Out of the 20 websites analyzed, 45% did not require a prescription, 75% lacked appropriate registration and 80% of the online pharmacies allowed consumers to make decisions based on dosage, antibiotic type and quantity.
“At present, there is no way to estimate the acquisition of antibiotics through legal or illegal online pharmacies. Education and public awareness campaigns should encourage prescribers to identify patients’ ideas, concerns and expectations, whilst fully explaining why they do not need an antibiotic,” researchers wrote. “Although the gains of this strategy have been modest to date, the prospect that a patient may seek to obtain an antibiotic from an alternative source, such as online, reinforces its importance.” – by Katherine Bortz
Disclosure: The researchers reported no relevant financial disclosures.
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