Antibiotic prescribing for acute uncomplicated cystitis
in Lebanese community pharmacies using a
Background: Urinary tract infections are considered as one of the most frequent bacterial infections in the community and hospital
settings. In this era of increasing antimicrobial resistance, antimicrobial stewardship has become highly important in the struggle to
preserve the effectiveness of available drugs. One the main causes of antibiotic resistance is the inappropriate prescribing of
antibiotics; which evidence show that community pharmacists contribute to.
Objective: This study aims to evaluate antibiotic prescribing rate and responses of the contact persons in community pharmacies and
to assess the conformity of the prescribed antibiotics with international guidelines. It also aims to evaluate the responses with
Methods: A cross-sectional, nationwide study conducted between February and May 2017 using a simulated patient case of acute
uncomplicated cystitis. Two hundred fifty pharmacies were included. Descriptive data was reported for the medications prescribed,
conformity, questions asked and counseling. Bivariate analysis using the Pearson chi-squared, Fisher’s exact and Student's t-tests were
used to identify possible factors affecting the prescribing rates and responses in community pharmacies.
Results: The prescribing rate of antibiotics was 83.6% (n=209) with ciprofloxacin being the most prescribed (50.2%, n=105). The global
conformity to international guidelines was 3.8% (n=8) with the highest conformity rate for the antibiotic choice (91.4%, n=191).
Counseling about what to do in case symptoms persist was 12.8% (n=32) and that of non-pharmacological management was 53.6%
(n=134). Male participants (88.1%) had a higher prescribing rate than female participants (77.6%) (p<0.05). The number of questions
asked was higher in pharmacists and in female participants (p<0.05). Other results showed non-significant differences in diagnosis,
antibiotic prescribing, conformity rates, referral rates and counseling points between the pharmacists and assistants.
Conclusions: The high antibiotic prescribing rate in Lebanese community pharmacies is alarming and calls for action. This should be
tackled by legislative bodies, which should enforce laws that restrict such practices.
Anti-Bacterial Agents; Urinary Tract Infections; Inappropriate Prescribing; Prescription Drug Overuse; Antimicrobial Stewardship; Drug
Resistance, Bacterial; Professional Practice; Pharmacies; Pharmacists; Counseling; Referral and Consultation; Patient Simulation; Cross-
Sectional Studies; Lebanon
deema wafic rahme
Pharmacy Practice,DOI: https://doi.org/10.18549/PharmPract.2019.4.1604, ISSN: 1885-642X, Volume: 4, Issue: 17, Pages Range: 1-8,