Abstract
A mismatch between available antibiotics in the healthcare outlets and limited medical and microbiological
capacities of these outlets can lead to irrational use of antibiotics and subsequently worsens
bacterial resistance situations. The study aims to investigate (a) patterns of antibiotic distribution and
utilization among health promoting hospitals, private medical clinics, and pharmacies; (b) opinions on regulation regarding antibiotic distribution and use; and (c) terminology used by health professionals to
explain to patients about antibiotics. A cross-sectional survey using self-administered questionnaires was
conducted in 27 districts of 9 purposely sampled provinces during April-May 2012. The response rate was
53% (601 questionnaires); 276 of them were from health promoting hospitals, 107 from private medical
clinics and 218 from pharmacies. The results showed that,of the 47 antibiotics surveyed; 25, 35 and 37
items were available at health promoting hospitals, medical clinics and pharmacies, respectively. The
most commonly found antibiotics were amoxicillin (98-100%), norfloxacin (93-99%) and dicloxacillin (85-
99%). Private medical clinics and pharmacies had higher rates of antibiotic utilization for potentially selflimited
diseases than those in health promoting hospitals (40-60% vs. 20-30%, correspondingly). Most
physicians in private medical clinics (77%) agreed with the prescription-only measure for all antibiotics.
Fewer nurses and other health professionals in health promoting hospitals and pharmacists in pharmacies
(24% and 5%, respectively) agreed with such measure. The terms “antimicrobial agents” (36-55%) and
“anti-inflammatory agents” (19-25%) are used more often than the term “antibiotics” (11-28%). The observations
from this study indicate that the regulation of antibiotic distribution should be more restrictive
and such regulatory measures, together with measures to promote rational use of antibiotics, should be
implemented simultaneously.
