Non-prescription antimicrobial use worldwide: a systematic review
Daniel J Morgan, Iruka N Okeke, Ramanan Laxminarayan, Eli N Perencevich, Scott Weisenberg, Daniel J Morgan, Iruka N Okeke, Ramanan Laxminarayan, Eli N Perencevich, Scott Weisenberg
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.
Conflict of interest statement
Conflicts of interest
DM and SW have received unrestricted research grants from Merck. ENP has received unrestricted research grants from Merck and Pfizer. INO and RL declare no conflicts of interest.
Copyright © 2011 Elsevier Ltd. All rights reserved.
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Source: PubMed