A point prevalence survey on antibiotic dispensing practices identifies targets for quality improvement of antimicrobial stewardship in community pharmacies in Dar es Salaam, Tanzania
Abstract
Background: Inappropriate antibiotic use is a major driver of antimicrobial resistance (AMR), especially in low- and middle-income countries (LMICs), where over-the-counter antibiotics are readily available without a prescription. This study assessed antibiotic dispensing practices in community pharmacies in Dar es Salaam, Tanzania.
Methodology: From February to March 2025, a point prevalence survey was conducted in 100 community pharmacies in Dar es Salaam. Researchers approached existing customers, obtained consent, and conducted confidential interviews. Five participants were enrolled per pharmacy, for a total of 500 participants.
Results: Overall, 64% (320/500) of community pharmacy attendees were dispensed antibiotics, of whom 71% (227/320) received them without a prescription. Access-group antibiotics were most frequently dispensed (56%, 201/356), followed by Watch (32%, 115/356) and Reserve groups (3%, 10/356), with metronidazole (15%, 53/356) and azithromycin (12%, 44/356) being the most commonly dispensed antibiotics. Urinary tract infection (UTI) was the leading indication (37%, 119/320), mainly treated with azithromycin (25%, 35/138), ciprofloxacin (12%, 16/138), and nitrofurantoin (7%, 9/138). Among antibiotic recipients, 44% (140/320) received antibiotics based on dispensers' recommendations. Ceftriaxone was commonly dispensed with prescriptions, while all Reserve antibiotics were dispensed without prescriptions. Participants with technical/vocational education…
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