E-DRUG: Non-prescription sale of antibiotics (9)
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Dear E-druggers,
In Thailand, by law, antibiotic both oral and topical/local forms are allowed to be
diispensed without prescription from class I pharmacies (with pharmacist in
charge). That is Pharmacy class of medicines. However, there are also illegal
distribution of antibiotics in drugstore class II (without pharmacist but nurse in
charge) or even in grocery. Some new drugs antibiotics may need precription or
dispensed in the hospital only.
Furthermore, there are evidence of overuse or irrational use of antibiotics in
hospital or clinics. These create the antibiotic resistance. Although there was a
move for national policy on antibiotic use, still ineffective implementation.
Scatters of studies or intervention of antibiotic rational use in some hospitals
were observed.
The third point, antibiotic in feed, farm, and fishery seemed to be neglected at the
moment.
New move on national antibotic policy is re-initiated recently. It is important to
explain problem of antibiotic resistance widely. We seem not to see the
immediate effect only when long term impact that we will suffer more. The
monitoring and enforcement of these situations are really needed.
Best wishes
Niyada
--
Niyada Kiatying-Angsulee, Ph.D.
Chair, Social Pharmacy Research Unit (SPR)
Faculty of Pharmaceutical Sciences
Chulalongkorn University
Phayathai Rd., Bangkok 10330, Thailand
T/F. +662-2188443
email: niyada.k@chula.ac.th
E-DRUG: Non-prescription sale of antibiotics (10)
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[See moderator's comments below. BS]
Dear E-druggers,
I want to have more examples of countries that allow, by law, pharmacists to
dispense antibiotics without a prescription and explore the basis for doing
that. I know in most African countries, a pharmacist is not allowed to
dispense an antibiotic without a prescription. Is it because the pharmacy
degree, in Thailand for example (CLASS 1), offers more clinical or case
management courses? What sort of procedures do they do before dispensing an
antibiotic?
Maybe this will be more important in countries where there is severe
shortage of doctors and nurses and clinical officers prescribe antibiotics!
I do not see why a pharmacist can be denied to dispense an antibiotic
without a prescription in a country where nurses can prescribe unlimitedly
antibiotics and other drugs, most of them without any laboratory test done!
Who is more knowledgeable in this area? THIS IS DEBATABLE!
Best wishes,
Langton Mukura
Pharmacist, B. Pharm Hons, mps
Christian Health Association of Malawi
P.O. Box 30378
Lilongwe 3
Malawi
Phone: +265-1-775 180
Mobile: +265-9-745 015
Email: lmukura@cham.org.mw
langtonmk@yahoo.co.uk
[In countries with Standard Treatment Guidelines, there will be step-wise recommendations for treatment. The levels of treatment will be matched in the Essential Medicines List by a symbol after each drug indicating the level at which it may be used.
In line with your example of professional staff shortages the treatment guidelines can specify that certain drugs (prescription only in developed countries), including certain antibiotics can be prescribed under particular conditions, for example at a remote clinic or pharmacy level by a suitably qualified staff member. Supervision and followup of this system is needed to ensure that the treatment guidelines are followed. My suggestion for Malawi and other similar settings is to activate your National Therapeutics Committee if it is not already active, and revise and promote the use of Standard Treatment Guidelines. BS]