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. 2017 May 1;72(5):1521-1528.
doi: 10.1093/jac/dkx003.

Obtaining antibiotics online from within the UK: a cross-sectional study

Sara Elizabeth Boyd  1   2 , Luke Stephen Prockter Moore  1   2 , Mark Gilchrist  1   2 , Ceire Costelloe  2 , Enrique Castro-Sánchez  2 , Bryony Dean Franklin  3   4 , Alison Helen Holmes  1   2
Affiliations

Obtaining antibiotics online from within the UK: a cross-sectional study

Sara Elizabeth Boyd et al. J Antimicrob Chemother. .

Abstract

Background: Improved antibiotic stewardship (AS) and reduced prescribing in primary care, with a parallel increase in personal internet use, could lead citizens to obtain antibiotics from alternative sources online.

Objectives: A cross-sectional analysis was performed to: (i) determine the quality and legality of online pharmacies selling antibiotics to the UK public; (ii) describe processes for obtaining antibiotics online from within the UK; and (iii) identify resulting AS and patient safety issues.

Methods: Searches were conducted for 'buy antibiotics online' using Google and Yahoo. For each search engine, data from the first 10 web sites with unique URL addresses were reviewed. Analysis was conducted on evidence of appropriate pharmacy registration, prescription requirement, whether antibiotic choice was 'prescriber-driven' or 'consumer-driven', and whether specific information was required (allergies, comorbidities, pregnancy) or given (adverse effects) prior to purchase.

Results: Twenty unique URL addresses were analysed in detail. Online pharmacies evidencing their location in the UK ( n = 5; 25%) required a prescription before antibiotic purchase, and were appropriately registered. Online pharmacies unclear about the location they were operating from ( n = 10; 50%) had variable prescription requirements, and no evidence of appropriate registration. Nine (45%) online pharmacies did not require a prescription prior to purchase. For 16 (80%) online pharmacies, decisions were initially consumer-driven for antibiotic choice, dose and quantity.

Conclusions: Wide variation exists among online pharmacies in relation to antibiotic practices, highlighting considerable patient safety and AS issues. Improved education, legislation, regulation and new best practice stewardship guidelines are urgently needed for online antibiotic suppliers.

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Figures

Figure 1
Figure 1
Flow diagram displaying results from a search performed on 28 February 2016.
Figure 2
Figure 2
Prescription requirements and processes for obtaining an antibiotic among sampled online pharmacies (n = 20).
Figure 3
Figure 3
Prescription and information requirements for obtaining an antibiotic among the top 20 online pharmacies analysed.
See this image and copyright information in PMC

References

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