Maryam Kotb1, Marwan ElBagoury2

1 University of The People, Pasadena, CA, USA

2 Universität Ulm – MedizinischeFakultät, Ulm, Deutschland


Background:Over the counter sale of antibiotics represents a worldwide threat and is progressively recognized as a basis of antibiotic misuse. In addition, it upsurges treatment costs, adverse effects of treatment, and development of resistance. The excessive practice of over the counter sale of antibiotics in Egypt rings a bell for the bad need to explore why such dispensing is taking place. The current study targets exploring the full picture of over the counter sale of antibiotics in the community pharmacies of Alexandria, Egypt.

Methods:A phenomenological qualitative study was carried out in 25 randomly selected community pharmacies in Alexandria, Egypt. A community pharmacist from each community pharmacy was interviewed using semi-structured, open-ended interview. Moreover, professionals’ dispensing practice was observed at each community pharmacy for at least two hours on the same day using an observation checklist. Answers were grouped into certain categories according to the objectives.

Results: All respondents indicated that antibiotics were commonly dispensed without prescription, and 60 % of them asserted that such a dispensing trend is progressive. The results showed that the nonprescription sales of antibiotics were common for Amoxicillin, Ciprofloxacin, and Azithromycin. Of the several categories of the population, the poor, under educated, and younger groups were recurrently reported for requesting antibiotics without prescription. The underlying causes for such trend were found to be associated with community pharmacy owner’s impact to achieve the best revenue, customer’s pressure, and underdeveloped regulatory system.

Keywords: Antibiotics, Over the counter, Nonprescription sale, Antibiotic resistance, Antimicrobial resistance,Community pharmacy, Alexandria, Egypt