E-DRUG: Non-prescription sale of antibiotics
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Dear E-DRUG Members,
I am interested in non-prescription use of antibiotics, specifically over
the counter sales and pharmacists' self-prescribing.
In many countries legislation prohibits the non-prescription sale of
antibiotics. I would like to find out more about the actual measures used
to enforce the legislation. I would appreciate hearing from E-DRUG members
about the measures in place in your country or any studies of measures to
enforce legislation or regulations prohibiting non-prescription sale of
antibiotics.
Kind regards,
Majd Dameh
BSc (Micro), BPharm, MHealSci, PhD Candidate
RegPharmNZ, MPS
Professional Pharmacy Practice
School of Pharmacy
University of Otago
PO Box 913,
Dunedin, New Zealand
M D <damma696@student.otago.ac.nz>
E-DRUG: Non-prescription sale of antibiotics (2)
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Dear E-Druggers
This is quite a hot issue at the moment in Malawi and I would be very
interested to receive more information. Pharmacists in retail are
prescribing and dispensing antibiotics without a prescription and recently
the regulatory board has clamped down on the law-breakers.
The problem in Malawi is most Doctors are still allowed to dispense and this
put a retail pharmacist useless because patients would get a prescription
and the drugs at the same time despite the law saying doctors should not
dispense within a 5km radius of a retail pharmacy. As a result of this,
retail pharmacies get very little prescriptions and may end up out of
business if they do not prescribe as well (including antibiotics).
I will be very interested to receive information on how other developing
countries are managing this problem.
Kind regards
Langton Mukura
Pharmacist, BPharm 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
E-DRUG: Non-prescription sale of antibiotics (3)
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In India, there is a legal prohibition on the sale of all antibiotics since they are "Prescription only" medicines (called Schedule H drugs). However there is rampant sale of antibiotics without prescription. Very little is being done to stop the violation. Reasons for patients self-medication are many such as reluctance to consult costly doctors, lack of faith in many doctors (due to their well publicised nexus with drug companies leading to irrational prescriptions) and not to mention very close proximity of retail drug stores leading to unethical competition. Sometimes there are half a dozen drug stores wall-to-wall. Hence if a pharmacy store refuses to sell an antibiotic without prescription, the next door drug store will sell thus putting the ethical retail drug store to loss of business.
Dr. Chandra M. Gulhati
Editor, MIMS
Chandra Gulhati <seeemgee@yahoo.co.uk>
E-DRUG: Non-prescription sale of antibiotics (6)
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In the Scandinavian countries all antibiotics execpt local treatment
(ointments, vaginal cream, tablets) are prescription only. Loyalty is
total, no need for special controls to enforce legislation.
Ms Kirsten Myhr, MScPharm, MPH
Head
RELIS Drug Info and Pharmacovigilance Centre
Ulleval University Hospital
0407 OSLO, Norway
kirsten.myhr@relis.ulleval.no
E-DRUG: Non-prescription sale of antibiotics (7)
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The situation in Canada is the same as in Scandinavia with regard to
antibiotics.
Joel Lexchin
--
Joel Lexchin MD
Professor
School of Health Policy and Management
Faculty of Health
York University
4700 Keele St.
Toronto ON
Canada M3J 1P3
Tel: 416-736-2100 x 22119
Fax: 416-736-5227
E mail: jlexchin@yorku.ca
[It is the same in Australia too. BS]
E-DRUG: Non-prescription sale of antibiotics (11)
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Dear Majd Dameh,
In Brazil the legislation prohibits the sale of antibiotics without
prescription. However, antibiotics are commonly sold without prescription.
We have three retail groups for medicines: "over the counter", sold freely
without a medical prescription, "red label", sold against presentation of a
medical prescription, and "black label", where the pharmacist keeps a copy
of the prescription. Antibiotics are red label medicines and, in practice,
the sale of red label medicines is free.
Best regards, Andréa
Andréa Dâmaso Bertoldi
Programa de Pós-graduação em Saúde Coletiva
Universidade do Vale do Rio dos Sinos - UNISINOS
Av. Unisinos, 950 - CEP: 93022-000
São Leopolodo, RS - Brazil
andreabertoldi@terra.com.br
E-DRUG: Guidelines on pharmaceutical waste disposal
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Dear all,
Do any of the countries have a guideline on the safe disposal of
pharmaceutical waste? we are in the process of developing one
and would really appreciate it if we could have use some of
yours as a reference.
Thanks.
Manusika Rai
Programme Manager
Essential Drugs Program
Ministry of Health
Bhutan
E-DRUG: Guidelines on pharmaceutical waste disposal (4)
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Here are some suggestions for guidelines if you do not have them already.
Perhaps you could indicate more details of what you are looking for and your
contact information so information can be sent to you directly.
You may wish to review local sanitation and hazardous waste disposal
requirements as a starting point and consider that different rules may be
appropriate for plastics, sharps, pills, liquid drugs, and other forms and
containers of pharmaceuticals.
Michele Forzley, JD, MPH
Professor
Health Law Institute
Widener School of Law
mforzley@comcast.net
E-DRUG: Guidelines on pharmaceutical waste disposal (6)
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You will find the interagency guidelines for disposal of medical waste at www.drugdonations.org/eng/richtlijnen/eng_richtlijnenmainpage.html
This document covers all the main principles and could be helpful for deciding what is appropriate in your own setting.
best wishes
Beverley
Beverley Snell
Centre for International Health
Macfarlane Burnet Institute for Medical Research and Public Health
P O Box 2284 Melbourne 8001, Australia
Telephone 61 3 9282 2115
Fax 61 3 9282 2144
email <bev@burnet.edu.au>