Evaluation of outpatient pharmacy staff practices in the dispensing and health education of antimicrobials in Colombia
DOI:
https://doi.org/10.60103/phc.v27.e892Keywords:
Antimicrobials, Rational Use of Medicines, Antimicrobial Resistance, Staff Pharmacy, Drugstores, PharmaciesAbstract
Introduction: Antimicrobial resistance is one of the top ten public health threats facing humanity. It is estimated that more than half of drugs worldwide are prescribed and dispensed inappropriately. In Colombia, community drugstores and ambulatory pharmacies play a critical role in the use of antimicrobials, highlighting the need to assess pharmacy staff practices, work dynamics, and perceptions regarding the risks associated with these drugs.
Objective: To evaluate the practices of pharmacy staff in the dispensing of antimicrobials and the provision of health education in community drugstores and ambulatory pharmacies in Colombia.
Methods: A cross-sectional study was conducted in establishments from different regions of Colombia, with a focus on the three main cities.
Results: A total of 134 individuals from the same number of establishments agreed to participate. Of these, 69% (n=92) worked in Bogota, Medellin, and Cali. The three most frequently dispensed antimicrobials were amoxicillin, azitromycin y cephalexin mainly for respiratory infections. However, 37.3% (n=50) of pharmacy staff reported dispensing them for nonspecific conditions such as colds, fever, and nasal congestion. Furthermore, 88.8% (n=119) expressed concern about antimicrobial resistance, and more than half acknowledged having witnessed inappropriate use in their workplaces.
Conclusions: Pharmacy staff practices in the dispensing and health education of antimicrobials at the ambulatory level reveal inappropriate and empirical behaviors, such as their use for mild symptoms, likely viral conditions, and unapproved indications. Although pharmacy staff perceive antimicrobial resistance as a critical issue, gaps remain, particularly in enforcing the requirement for a medical prescription to dispense these medicines. This underscores the need to strengthen regulatory policies and training programs.
Downloads
References
World Health Organization (WHO). Antibiotic Resistance. Citado 18 de junio 2024. Disponible en: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
Plan Nacional de Respuesta a la Resistencia a los Antimicrobianos OPS/OMS. Citado 18 de junio de 2024. Disponible en: https://www.paho.org/es/documentos/plan-nacional-respuesta-resistencia-antimicrobianos-junio-2018
Dadgostar P. Antimicrobial Resistance: Implications and Costs. Infect Drug Resist. 2019;12:3903-3910. doi: 10.2147/IDR.S234610.
Vera O. Uso racional de medicamentos y normas para las buenas prácticas de prescripción. Revista Médica La Paz. 2020;26(2):78-93.
Auta A, Hadi MA, Oga E, Adewuyi EO, Abdu-Aguye SN, Adeloye D, et al. Global access to antibiotics without prescription in community pharmacies: A systematic review and meta-analysis. J Infect. 2019;78(1):8-18. doi: 10.1016/j.jinf.2018.07.001
Organización Panamericana de la Salud. Organización Mundial de la Salud. La experiencia de Colombia en la fiscalización de la venta de antimicrobiano. [Internet]. [citado 25 de septiembre de 2024]. Disponible en: https://www.paho.org/es/sistemas-servicios-salud/experiencia-colombia-fiscalizacion-venta-antimicrobianos
Vacca C, Yaneth C, Reveiz L. Restricción de la venta de antibióticos en farmacias de Bogotá, Colombia: estudio descriptivo. Rev Panam Salud Publica. 2011;30(6):586-91. Disponible en: https://iris.paho.org/handle/10665.2/9416
Fajardo-Zapata A, Méndez-Casallas F, Hernández-Niño J, Molina L, Tarazona M, Nossa C et al. La automedicación de antibióticos: un problema de salud pública. Salud, Barranquilla. 2013;29(2):226-235. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-55522013000200008&lng=en.
de Souza EV, Vieira LJSC, Dos Santos SNP, Cerqueira-Santos S, Rocha KSS, de Lyra DP Jr. Antimicrobial dispensing process in community pharmacies: a scoping review. Antimicrob Resist Infect Control. 2022;11(1):116. doi: 10.1186/s13756-022-01157-0.
Li B, Webster TJ. Bacteria antibiotic resistance: New challenges and opportunities for implant-associated orthopedic infections. J Orthop Res. 2018;36(1):22–32. doi: 10.1002/jor.23656
Amariles P, Ceballos M, González-Giraldo C. Primary health care policy and vision for community pharmacy and pharmacists in Colombia. Pharm Pract. 2020;18(4):2159-2159. doi: 10.18549/PharmPract.2020.4.2159
Buxton JA, Babbitt R, Clegg CA, Durley SF, Epplen KT, Marsden LM, et al. ASHP guidelines: Minimum standard for ambulatory care pharmacy practice. Am J Health Syst Pharm. 15 de julio de 2015;72(14):1221-36. doi: 10.2146/sp150005
Ceballos M, Llano Y, Salazar-Ospina A, Madrigal-Cadavid J, Pino-Marín D, Amariles P. Skills and practices of pharmacy staff for dispensing of drugs with fiscalized substances in drugstores and pharmacies. Rev Saude Publica. 2021;55:44. doi: 10.11606/s1518-8787.2021055003103
Ceballos M, Andrea SO, Daniel SH, Pedro A. Effectiveness of a continuing education program of drugs with fiscalized substance to improve pharmacy staff competencies: A multicenter, cluster-randomized controlled trial. Pharm Pract. 2022;20(3):2632. doi: 10.18549/PharmPract.2022.3.2632
Ceballos M, Salazar-Ospina A, Sabater-Hernández D, Amariles P. Evaluation of the effects of a drug with fiscalized substance dispensation, health education, and pharmacovigilance continuing education program in Colombia drugstores and drugstores/pharmacies: study protocol of a multicenter, cluster-randomized controlled trial. Trials. 19 de junio de 2020;21(1):545. doi: 10.1186/s13063-020-04481-1
Ceballos M, Giraldo JA, Marín VH, Amariles P. Caracterización de aspectos relacionados con la utilización de los medicamentos fiscalizados en droguerías y farmacias-droguerías de Medellín y el Área Metropolitana. Rev Univ Ind Santander Salud. marzo de 2018;50(1):27-36. doi: 10.18273/revsal.v50n1-2018003
Arroyave O, Álvarez V, Amariles, P, Vásquez, M, Cardona B. Pertinencia laboral y social del programa de Tecnología en Regencia de Farmacia en la región de Urabá. Salud UIS. 2016;48(4). doi: 10.18273/revsal.v48n4-2016011
Giono-Cerezo S, Santos-Preciado J, Rayo M, Torres-López F, Alcántar-Curiel M. Resistencia antimicrobiana. Importancia y esfuerzos por contenerla. Gac. Méd. Méx. 2020;156(2):172-180. doi: 10.24875/gmm.20005624.
Hashmi A, Ul Haq MI, Malik M, Hussain A, Gajdács M, Jamshed S. Perceptions of community pharmacists regarding their role in antimicrobial stewardship in Pakistan: A way forward. Heliyon. 2023;9(4):e14843. doi: 10.1016/j.heliyon.2023.e14843
Frieri M, Kumar K, Boutin A. Antibiotic resistance. J Infect Public Health. 2017;10(4):369-378. doi: 10.1016/j.jiph.2016.08.007
Restrepo-Arbeláez N, Garcia-Betancur JC, Pallares CJ, Villegas MV. Antimicrobial Stewardship Programs in Latin America and the Caribbean: A Story of Perseverance, Challenges, and Goals. Antibiotics (Basel). 2023;12(8):1342. doi: 10.3390/antibiotics12081342.
Colonia, D.R.M, Ramírez Patiño, D.; Higuita-Gutiérrez, L.F. Knowledge, Attitudes, and Practices Regarding Antibiotic Sales in Pharmacies in Medellín, Colombia 2023. Antibiotics 2023; 12:1456. doi:10.3390/antibiotics12091456
Kandeel A, Palms D, Afifi S, Kandeel Y, Etman A, Hicks L, Talaat M. An educational intervention to promote appropriate antibiotic use for acute respiratory infections in a district in Egypt- pilot study. BMC Public Health 2019;19(3):498. doi: 10.1186/s12889-019-6779-0
Duan L, Liu C, Wang D, Lin R, Qian P, Zhang X, Liu C. The vicious cycle of the public’s irrational use of antibiotics for upper respirator y tract infections: A mixed methods systematic review. Public Health 2022; 10:985188. doi: 10.3389/fpubh.2022.985188
Herrera Carranza J. Objectives of pharmaceutical care. Aten Primaria. 2002;30(3):183-7. doi: 10.1016/s0212-6567(02)79001-x.
López-Mejía Y, Guzmán NNA, Paternina D, Guzmán C, Camargo F, Beltrán M, et al. Dramatic increase in consumption of antibiotics in Colombia, 2020-2023. Biomédica [Internet]. 2026 [citado 22 de agosto de 2025];46(1). Disponible en: https://revistabiomedica.org/index.php/biomedica/article/view/7702
Arboleda Forero V, Cruzate Hernández JP, Yepes Restrepo M, Higuita-Gutiérrez LF. Antibiotic Self-Medication Patterns and Associated Factors in the Context of COVID-19, Medellín, Colombia: A Survey Based Cross Sectional Study. Patient Prefer Adherence. 23 de noviembre de 2023; 17:3057-66. doi: 10.2147/PPA.S434030
Organización Mundial de la Salud. Plan de acción mundial sobre la resistencia a los antimicrobianos. Disponible en: https://www.who.int/es/publications/i/item/9789241509763
Caribe CE para AL y el. La Agenda 2030 y los Objetivos de Desarrollo Sostenible: una oportunidad para América Latina y el Caribe. Objetivos, metas e indicadores mundiales CEPAL; 2019. Disponible en: https://www.cepal.org/es/publicaciones/40155-la-agenda-2030-objetivos-desarrollo-sostenible-oportunidad-america-latina-caribe
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Javier Mauricio Ceballos Rueda, Leidy Patricia Gomez Marin, Isabel Arias Castaño
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
La revista Pharmaceutical Care España se publica bajo una licencia «Creative Commons, Reconocimiento, No Comercial y Compartir Igual 4.0 Internacional» (CC BY-NC-SA 4.0)», que permite a otros compartir el trabajo con un reconocimiento de la autoría del trabajo y la publicación inicial en esta revista (con excepción de los usos comerciales).
Los autores que publican en esta revista están de acuerdo con los siguientes términos:a) Los autores conservan los derechos de autor (derechos morales) y garantizan a la revista el derecho de ser el primer soporte documental publicado del trabajo.
b) Se permite y anima a los autores a difundir la versión del trabajo revisado por pares y aceptada para su publicación (por ejemplo, en repositorios institucionales o temáticos), recomendando hacerlo con la versión final del editor “pdf”, “html” o “xml”).
