Batista, Ana DanielaRodrigues, Daniela A.Figueiras Guzmán, AdolfoZapata Cachafeiro, MaruxaRoque, FátimaHerdeiro, Maria Teresa Ferreira2020-12-172020-12-172020Batista, A.D.; A. Rodrigues, D.; Figueiras, A.; Zapata-Cachafeiro, M.; Roque, F.; Herdeiro, M.T. Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review. Antibiotics 2020, 9, 786http://hdl.handle.net/10347/24051Antibiotic resistance still remains a major global public health problem and the dispensing of antibiotics without a prescription at community pharmacies is an important driver of this. MEDLINE, Pubmed and EMBASE databases were used to search and identify studies reporting the dispensing of non-prescribed antibiotics in community pharmacies or drugstores that sell drugs for human use, by applying pharmacy interviews/questionnaires methods and/or simulated patient methods. Of the 4683 studies retrieved, 85 were included, of which 59 (69.4%) were published in low-and middle-income countries. Most of the papers (83.3%) presented a percentage of antibiotic dispensing without a prescription above 60.0%. Sixty-one studies evaluated the active substance and the most sold antibiotics without a prescription were amoxicillin (86.9%), azithromycin (39.3%), ciprofloxacin (39.3%), and amoxicillin-clavulanic acid (39.3%). Among the 65 articles referencing the diseases/symptoms, this practice was shown to be mostly associated with respiratory system problems (100.0%), diarrhea (40.0%), and Urinary Tract Infections (30.8%). In sum, antibiotics are frequently dispensed without a prescription in many countries and can thus have an important impact on the development of resistance at a global level. Our results indicate the high need to implement educational and/or regulatory/administrative strategies in most countries, aiming to reduce this practiceeng© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)Atribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/AntibioticsNon-prescription antibiotic dispensingPharmacy practiceSelf-medicationjournal article10.3390/antibiotics91107862079-6382open access