Non-prescription sale of antibiotics in pharmacies across Puducherry, India

Mohan Jaganathan, Vallish BN, Brahadeesh Mayathevar, Raj Kishore Mahato


Background: Despite being illegal, non-prescription sales of antibiotics in India continue to be a major contributor to antibiotic abuse, which fosters antibiotic resistance.

Methods: Two trained actors simulated symptoms of acute gastroenteritis (AGE) and upper respiratory tract infections (URTI) in 60 pharmacies each randomly selected in the Union Territory of Pondicherry, India. The ease of obtaining antibiotics, any additional enquiries made by the pharmacies, and any additional advise given were noted.

Results: Only 33/120 pharmacies (27.5%) declined to dispense antibiotics without prescription; all 33 were attached to a hospital or nursing home. The most frequently dispensed antibiotics for AGE and URTI were ciprofloxacin (41.4%) and coamoxiclav (41.3%) respectively. Out of the 87 pharmacies which dispensed antibiotics without prescription, the presence of additional symptoms and previous drug allergy were enquired by 20 (22.9%) and 9 (10.3%) pharmacies respectively. While over half of the pharmacies gave instructions regarding dose, duration and frequency of antibiotic consumption, none of the pharmacies provided information regarding adverse reaction profile of antibiotics. Non-pharmacological measures for symptomatic improvement were advised by 24/120 pharmacies (20%).

Conclusions: Non-prescription sales of antibiotics are unacceptably high in Pondicherry. Stricter implementation of the law and public awareness of the perils of inappropriate antibiotic usage are the need of the hour.


Antibiotics, Acute gastroenteritis, Non-prescription usage, Pharmacies, Upper respiratory tract infection

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Bi P, Tong S, Parton KA. Family self-medication and antibiotics abuse for children and juveniles in a Chinese city. Soc Sci Med. 2000;50:1445-50.

Sturm AW, van der Pol R, Smits AJ, van Hellemondt FM, Mouton SW, Jamil B, et al. Over-the-counter availability of antimicrobial agents, self-medication and patterns of resistance in Karachi, Pakistan. J Antimicrob Chemother. 1997;39:543-7.

Llor C, Cots JM. The sale of antibiotics without prescription in pharmacies in Catalonia, Spain. Clin Infect Dis. 2009;48:1345-9.

Gebretekle GB, Serbessa MK. Exploration of over the counter sales of antibiotics in community pharmacies of Addis Ababa, Ethiopia: pharmacy professionals' perspective. Antimicrob Resist Infect Control. 2016;5:2

Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. Lancet Infect Dis. 2011;11:692-701.

Hazra A. Schedule H1: Hope or hype? Indian J Pharmacol. 2014;46:361–2.

Hello Medical Shops. Available at Last accessed 6th Nov 2016.

Zollner-Schwetz I, Krause R. Therapy of acute gastroenteritis: role of antibiotics. Clin Microbiol Infect. 2015;21:744-9.

Vinnard C, Linkin DR, Localio AR, Leonard CE, Teal VL, Fishman NO, et al. Effectiveness of interventions in reducing antibiotic use for upper respiratory infections in ambulatory care practices. Popul Health Manag. 2013;16:22-7.

Smucny J, Fahey T, Becker L, Glazier R, McIsaac W. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2000;(4):CD000245.

Kotwani A, Holloway K. Access to antibiotics in New Delhi, India: implications for antibiotic policy. J Pharm Policy Pract. 2013;6:6.

Shet A, Sundaresan S, Forsberg BC. Pharmacy-based dispensing of antimicrobial agents without prescription in India: appropriateness and cost burden in the private sector. Antimicrob Resist Infect Control. 2015;4:55.