PERSPECTIVE Year : 2022  |  Volume : 15  |  Issue : 8  |  Page : 341-342

Inappropriate antibiotic dispensing and use: A public health threat in the Philippines

Eric David B. Ornos, Elgin Paul B. Quebral, Jeremy A Ceriales, Ourlad Alzeus G. Tantengco
College of Medicine, University of the Philippines Manila, Manila, Philippines

Date of Submission12-Jun-2022Date of Decision13-Jul-2022Date of Acceptance21-Jul-2022Date of Web Publication30-Aug-2022

Correspondence Address:
Eric David B. Ornos
College of Medicine, University of the Philippines Manila, Manila
Philippines

Source of Support: The authors received no extramural funding for the study, Conflict of Interest: None

DOI: 10.4103/1995-7645.354417

How to cite this article:
Ornos ED, Quebral EP, Ceriales JA, Tantengco OA. Inappropriate antibiotic dispensing and use: A public health threat in the Philippines. Asian Pac J Trop Med 2022;15:341-2
How to cite this URL:
Ornos ED, Quebral EP, Ceriales JA, Tantengco OA. Inappropriate antibiotic dispensing and use: A public health threat in the Philippines. Asian Pac J Trop Med [serial online] 2022 [cited 2022 Aug 31];15:341-2. Available from: https://www.apjtm.org/text.asp?2022/15/8/341/354417
A high rate of improper antibiotic dispensing was reported to patients with presumed viral infections even without a prescription from a physician in Vietnam[1]. Imprudent antibiotic dispensing and use were also observed in other countries, including the Philippines. A large number of patients experienced respiratory symptoms, such as cough and rhinorrhea during the COVID-19 pandemic, which exacerbated this problem with antibiotic use.

The Philippine Food and Drug Administration strictly prohibits the selling or dispensing of antibiotics without a prescription from a licensed physician. However, patients can still purchase antibiotics without a prescription in the Philippines[2]. Patients perceive that they can easily buy antibiotics even without a doctor’s prescription[2]. This high rate of antibiotic self-medication can be attributed to Filipino’s limited understanding of proper antibiotic use. For instance, Filipino mothers usually give antibiotics to their children with coughs even without a doctor’s prescription[3]. Patients also reuse their previous medical prescriptions to get antibiotics from pharmacies. The lack of access to physicians and the high cost of medical consultation also contribute to the rampant self-medication of antibiotics[1].

The COVID-19 pandemic has aggravated the issue of inappropriate antibiotic dispensing. At the start of the COVID-19 pandemic, ivermectin and azithromycin were promoted in the treatment for COVID-19. The Philippine Department of Health and different medical societies recommended against their use due to the lack of evidence that they can prevent COVID-19 infection, decrease disease progression, and reduce the duration of hospitalization[4]. However, some physicians still prescribed these drugs and resisted the directives of health authorities. Unfortunately, the lack of policing for drug dispensing in pharmacies aggravated the dysregulated access of the public to antibiotics[5].

Inappropriate antibiotic use is a threat to public health because it can promote antimicrobial resistance[6]. We call for interprofessional collaboration to promote antimicrobial stewardship. Physicians should be prudent in prescribing antibiotics to their patients. Health workers should educate their patients to increase their knowledge of proper antibiotic use. Pharmacists should also practice appropriate dispensing of antibiotics. We also emphasize the need for regulatory bodies to adequately implement and check the adherence of health workers and pharmacies to the guidelines and regulations on antibiotic dispensing. We call for increased vigilance and commitment among all stakeholders to take immediate action against improper antibiotic use.

Conflict of interest statement

The authors declare no competing interests.

Funding

The authors received no extramural funding for the study.

Authors’ contributions

EDBO conceived and wrote the manuscript. EPBQ, JAC, and

OAGT reviewed the manuscript. All the authors approved the finally version to be published.

 

  References 
1.Zawahir S, Le HT, Nguyen TA, Beardsley J, Dang AD, Bernays S, et al. Inappropriate supply of antibiotics for common viral infections by community pharmacies in Vietnam: A standardised patient survey. Lancet Regional Health-Western Pac 2022. doi: 10.1016/j.lanwpc.2022.100447.  
    2.Barber DA, Casquejo E, Ybañez PL, Pinote MT, Casquejo L, Pinote LS, et al. Prevalence and correlates of antibiotic sharing in the Philippines: Antibiotic misconceptions and community-level access to non-medical sources of antibiotics. Trop Med Intern Health 2017; 22(5): 567-575.  
    3.Bulario JS, Cruz IL, Pilapil MC, Gutierrez MM. Factors associated with parental self-medication of antibiotics in Health Centers of Manila. KnE Soc Sci 2018; 3(6): 891-910.  
    4.Institute of Clinical Epidemiology, National Institutes of Health, UP Manila. Philippine COVID-19 living recommendations. Philippine society for microbiology and infectious diseases. [Online]. Available from: https:// www.psmid.org/wp-content/uploads/2021/04/Living-Recommendations-UPDATED-27April2021-2.pdf. [Accessed on 20 April 2022].  
    5.Baclig CE. New clinical trial shows ivermectin ineffective vs. COVID. [Online]. Available from: https://newsinfo.inquirer.net/1576409/for-posting-edited-new-clinical-trial-shows-ivermectin-ineffective-vs- covid#ixzz7QqZt9DwV. [Accessed on 20 April 2022].  
    6.Mostafavi S N, Rostami S, Nokhodian Z, Ataei B, Cheraghi A, Ataabadi P, et al. Antibacterial resistance patterns of Acinetobacter baumannii complex: The results of Isfahan Antimicrobial Resistance Surveillance-1 Program. Asian Pac J Trop Med 2021; 14(7): 316.