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. 2023 Mar 2;3(1):e40.
doi: 10.1017/ash.2022.357. eCollection 2023.

Dispensing of antibiotics without prescription in the metropolitan area of Athens, Greece, in 2021-Can new legislation change old habits?

Ioannis Kopsidas  1   2 , Lydia Kokkinidou  2 , Dioni Pinelopi Petsiou  2 , Eleni Kourkouni  2 , Christos Triantafyllou  2 , Grammatiki-Christina Tsopela  2 , Theoklis Zaoutis  1   2
Affiliations

Dispensing of antibiotics without prescription in the metropolitan area of Athens, Greece, in 2021-Can new legislation change old habits?

Ioannis Kopsidas et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Objective: To assess the effect of new legislation on the dispensing of antimicrobials without prescription from pharmacies in Greece.

Design: In-person survey.

Setting: The study included 110 pharmacies in the greater Athens Metropolitan area.

Methods: Volunteer collaborators visited 110 pharmacies in the greater Athens Metropolitan area in December 2021 and January 2022. They asked for either ciprofloxacin or amoxicillin-clavulanate acid (6:5 ratio) without providing a prescription, without simulating symptoms, and without offering justification or insisting. Fluoroquinolones have additional dispensing restrictions in Greece. Results were compared to a 2008 study. In 2020, legislation allowed the dispensing of antibiotics from pharmacies only with an electronic prescription, overriding the 1973 forbidding the dispensing of all medications without prescriptions.

Results: All pharmacists refused to dispense ciprofloxacin without a prescription. Only 1 pharmacy dispensed amoxicillin-clavulanate without a prescription. Compared to the 2008 study, dispensing of amoxicillin-clavulanate without a prescription dropped from 100% in 2008 to 1% in 2021 and dispensing ciprofloxacin without a prescription dropped from 53% in 2008 to 0% in 2021.

Conclusions: A new and enforced law that requires electronic prescribing led to a dramatic reduction of antibiotic dispensing without prescription compared to 12 years ago. Similar initiatives could help solve the problem of antibiotic consumption and resistance in Greece and elsewhere.

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Conflict of interest statement

No author has any relevant conflicts of interest to declare related to this article.

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