Magnitude of dispensing unprescribed antibiotics in community pharmacies in Duhok province; Kurdistan region of Iraq

Objectives: study aims to provide a descriptive overview about the magnitude and frequency of dispensing the unprescribed antibiotics UABs. It furthermore aims, to specify the most dispensed UAB types, the most common infections, signs and symptoms that require dispensing the UABs in community pharmacies of Duhok city and its districts.  Methods: A cross sectional cohort study had been conducted from September to October 2022, private community pharmacies of Duhok province were included in this study. A standardized questionnaire platform was utilized to complete the survey, it included 2 sections, the first of which was related to demographic data and the second part included details of the dispensing unprescribed antibiotics UABs like: what are the most common dispensed UABs, what are the most common illness and symptoms of patients who require dispensing UABs. Results: One hundred fifty pharmacies have been included in this study. The majorities were from Duhok city 46%, and Zakho 28.7%. The prevalence of dispensing UABs was 100%, the three most common dispensed UABs were Amoxicillin 77%, followed by azithromycin 16% and cefixime 7%. The most infections and conditions requiring dispensing UABs were tonsilitis (69.3%), followed by flu and common cold (58.7%), and lower respiratory tract infection (48.7%). Conclusion: This study concluded that dispensing UABs is a frequent practice in Duhok community pharmacies. Viruses are the most common cause of upper respiratory tract infections; hence, antibiotics must be avoided and OTC medicines should be encouraged to alleviate the symptoms. Continuing medical education through training pharmacists on dispensing antibiotics by adhering to the regulations of antibiotic stewardship is crucial.