Logo image
Non-prescription antimicrobial use worldwide: a systematic review
Journal article   Open access   Peer reviewed

Non-prescription antimicrobial use worldwide: a systematic review

Daniel J Morgan, Iruka N Okeke, Ramanan Laxminarayan, Eli N Perencevich and Scott Weisenberg
The Lancet. Infectious diseases, Vol.11(9), pp.692-701
06/08/2011
DOI: 10.1016/S1473-3099(11)70054-8
PMCID: PMC3543997
PMID: 21659004

View Online

Abstract

In much of the world antimicrobial drugs are sold without prescription or oversight by health-care professionals. The scale and effect of this practice is unknown. We systematically reviewed published works about non-prescription antimicrobials from 1970-2009, identifying 117 relevant articles. 35 community surveys from five continents showed that non-prescription use occurred worldwide and accounted for 19-100% of antimicrobial use outside of northern Europe and North America. Safety issues associated with non-prescription use included adverse drug reactions and masking of underlying infectious processes. Non-prescription use was common for non-bacterial disease, and antituberculosis drugs were available in many areas. Antimicrobial-resistant bacteria are common in communities with frequent non-prescription use. In a few settings, control efforts that included regulation decreased antimicrobial use and resistance. Non-prescription antimicrobial and antituberculosis use is common outside of North America and northern Europe and must be accounted for in public health efforts to reduce antimicrobial resistance.
Anti-Bacterial Agents - therapeutic use Drug Resistance, Microbial Nonprescription Drugs - therapeutic use Internationality Humans Anti-Bacterial Agents - adverse effects Nonprescription Drugs - adverse effects

Details

Logo image