# Utilisation of antibiotics in a community pharmacy: A case from north-west, South Africa

## TL;DR

This study examines antibiotic use in a South African community pharmacy to understand patterns and improve antimicrobial resistance efforts.

## Contribution

The study provides insights into antibiotic dispensing practices in a specific South African region using WHO categories and prescription data.

## Key findings

- Access antibiotics were most commonly dispensed, but Watch antibiotics like azithromycin were frequently prescribed.
- Most prescriptions were linked to non-specific disease codes, and generic medicines dominated prescriptions.
- Cash-paying patients were more likely to receive generic antibiotics compared to medical aid users.

## Abstract

Antibiotic utilisation is a growing public health issue due to antimicrobial resistance. Community pharmacies are a key access point for antibiotics; thus, an evaluation of dispensing records will provide insights into their use.

To describe the utilisation of antibiotics in a private community pharmacy.

This study was undertaken in a private pharmacy located in the North West province of South Africa.

A retrospective, cross-sectional study reviewed electronic dispensing records of oral antibiotics from January 2022 to August 2024, categorising them according to the World Health Organizations (WHO) Access, Watch and Reserve categories, generic status, diagnosis and payment methods.

A total of 10 468 antibiotic dispensing records were analysed. Adults (18–64 years) accounted for the majority of prescriptions (80.7%; n = 8446). Overall, Access antibiotics were mostly dispensed (56.5%; n = 5910); however, azithromycin, a Watch antibiotic, was the most dispensed antibiotic (n = 1849). Notably, 82% (n= 8584) of prescriptions were linked to non-specific International Classification of Diseases, 10th Revision codes. Generic medicines constituted 92.6% (n = 9694) of prescriptions. Although most patients (72.8%) used medical aid, cash-paying patients were more likely to be dispensed a generic antibiotic.

Antibiotic prescribing largely aligned with WHO guidelines; however, the high rate of Access antibiotics dispensed highlights the need for targeted interventions to improve prescribing practices and guideline adherence.

This case study indicates that dispensing records contribute to improved understanding of local antibiotic usage patterns that can help combat antimicrobial resistance within a community.