ANALISIS FAKTOR RESIKO PENYEBAB PELAYANAN ANTIBIOTIK TANPA RESEP DOKTER DI APOTEK: A REVIEW

  • Helma Malini Marol Tupak Program Studi Magister Farmasi, Fakultas Farmasi, Universitas Jenderal Achmad Yani, Cimahi, Indonesia
  • Suci Nar Vikasari Departemen Farmakologi dan Farmasi Klinis, Fakultas Farmasi, Universitas Jenderal Achmad Yani, Cimahi, Indonesia
Keywords: Risk factors, antibiotic misuse, antibiotic sales, antibiotic purchases, community pharmacy practices

Abstract

The dispensing of antibiotics without a doctor’s prescription in pharmacies remains a common practice and contributes significantly to the rise of antibiotic resistance, which poses a major threat to public health. This phenomenon is driven by interrelated risk factors, including easy access, limited public knowledge, socioeconomic influences, and weak regulatory enforcement. This study aims to identify the risk factors underlying the dispensing of antibiotics without prescriptions in pharmacies. A literature review was conducted by collecting and analyzing Indonesian and English journal articles published between 2015 and 2025. Data were retrieved from Google Scholar and PubMed using keywords related to the sale and purchase of antibiotics without a doctor’s prescription. The findings were analyzed narratively and grouped into three perspectives: business actors, patients or consumers, and regulators. From the perspective of business actors, the risk factors include pharmacy staff attitudes that facilitate non-prescription antibiotic sales, financial motivations, consumer pressure and demand, and insufficient professional knowledge. From the perspective of patients, risk factors involve the ease of obtaining antibiotics without a prescription, economic, social, and cultural influences, lack of awareness and understanding, and prior personal experiences of antibiotic use. From the perspective of regulators, weak supervision and poor law enforcement remain key drivers of this practice. In conclusion, comprehensive efforts are required to address this issue. These include strengthening regulations, improving public education, and enhancing the training of pharmacy personnel. Such interventions are critical to preventing antibiotic misuse and mitigating the long-term consequences of antibiotic resistance on public health.

References

Ahiabu, M. A., Magnussen, P., Bygbjerg, I. C., & Tersbøl, B. P. (2018). Treatment Practices Of Households And Antibiotic Dispensing In Medicine Outlets In Developing Countries: The Case Of Ghana. Research in Social and Administrative Pharmacy, 14(12): 1180–1188.https://doi.org/10.1016/j.sapharm.2018.01.013

Alajmi, A. M., Alamoudi, A. A., Halwani, A. A., Almangour, T. A., Almozain, N. H., Al-Jedai, A., & Tawfik, E. A. (2023). Antimicrobial Resistance Awareness, Antibiotics Prescription Errors and Dispensing Patterns by Community Pharmacists in Saudi Arabia. Journal of Infection and Public Health, 16(1):34–41. https://doi.org/10.1016/j.jiph.2022.11.026

Chang, J., Ye, D., Lv, B., Jiang, M., Zhu, S., Yan, K., Tian, Y., & Fang, Y. (2017). Sale Of Antibiotics Without A Prescription At Community Pharmacies In Urban China: A Multicentre Cross-Sectional Survey. Journal of Antimicrobial Chemotherapy, 72(4):1235–1242. https://doi.org/10.1093/jac/dkw519

Djawaria, D. P. A., Setiadi, A. P., & Setiawan, E. (2018a). Analisis Perilaku dan Faktor Penyebab Perilaku Penggunaan Antibiotik Tanpa Resep di Surabaya. Media Kesehatan Masyarakat Indonesia, 14(4):406. https://doi.org/10.30597/mkmi.v14i4.5080

Djawaria, D. P. A., Setiadi, A. P., & Setiawan, E. (2018). Pengembangan Kuesioner dan Identifikasi Faktor Penyebab Penjualan Antibiotik Tanpa Resep Dokter di Komunitas Kota Surabaya. Jurnal Manajemen Dan Pelayanan Farmasi, 8(3):105–118. http://repository.ubaya.ac.id/id/eprint/34134

Gong, Y., Jiang, N., Chen, Z., Wang, J., Zhang, J., Feng, J., & Yin, X. (2020). Over-the-counter Antibiotic Sales In Community And Online Pharmacies , China. March, 449–457.

Kaae, S., Ghazaryan, L., Pagava, K., Korinteli, I., Makalkina, L., Zhetimkarinova, G., Ikhambayeva, A., Tentiuc, E., Ratchina, S., Zakharenkova, P., Yusufi, S., Maqsudova, N., Druedahl, L., Sporrong, S. K., Cantarero, L. A., & Nørgaard, L. S. (2020). The Antibiotic Knowledge, Attitudes And Behaviors Of Patients, Doctors And Pharmacists In The WHO Eastern European Region – A Qualitative, Comparative Analysis Of The Culture Of Antibiotic Use in Armenia, Georgia, Kazakhstan, Moldova, Russia and Tajikista. Research in Social and Administrative Pharmacy, 16(2):238–248. https://doi.org/10.1016/j.sapharm.2019.05.014

Khalifeh, M. M., Moore, N. D., & Salameh, P. R. (2017). Self-medication Misuse In The Middle East: A Systematic Literature Review. Pharmacology Research and Perspectives, 5(4):1–13. https://doi.org/10.1002/prp2.323

Kliemann, B. S., Levin, A. S., Moura, M. L., Boszczowski, I., & Lewis, J. J. (2016). Socioeconomic Determinants Of Antibiotic Consumption In The State Of São Paulo, Brazil: The Effect Of Restricting Over-The-Counter Sales. PLoS ONE, 11(12):1–14. https://doi.org/10.1371/journal.pone.01678

Kotwani, A., Joshi, J., & Lamkang, A. S. (2021). Over-the-counter Sale Of Antibiotics In India: A Qualitative Study Of Providers Perspectives Across Two States. Antibiotics, 10(9):1–19. https://doi.org/10.3390/antibiotics10091123

Kotwani, A., Joshi, J., Lamkang, A. S., Sharma, A., & Kaloni, D. (2021). Knowledge and Behavior Of Consumers Towards The Non-Prescription Purchase Of Antibiotics: An Insight From A Qualitative Study From New Delhi, India. Pharmacy Practice, 19(1):1–11. https://doi.org/10.18549/PharmPract.2021.1.2206

Le, N. M. T., Dang, K. D., & Nguyen, H. P. (2024). The Attitude, Intention, And Related Factors Of Purchasing Antibiotics Without Prescription: A Survey in Vietnam. Annali Di Igiene : Medicina Preventiva e Di Comunita, 36(6):668–682. https://doi.org/10.7416/ai.2024.2635.

Markovic-Pekovic, V., Grubiša, N., Burger, J., Bojanić, L., & Godman, B. (2017). Initiatives to Reduce Nonprescription Sales And Dispensing Of Antibiotics: Findings And Implications. Journal of Research in Pharmacy Practice, 6(2):120. https://doi.org/10.4103/jrpp.jrpp_17_12

Mokwele, R. N., Schellack, N., Bronkhorst, E., Brink, A. J., Schweickerdt, L., & Godman, B. (2022). Using Mystery Shoppers To Determine Practices Pertaining To Antibiotic Dispensing Without A Prescription Among Community Pharmacies in South Africa - a pilot survey. JAC-Antimicrobial Resistance, 4(1):1–10. https://doi.org/10.1093/jacamr/dlab196

Moreno, P., Cerón, A., Sosa, K., Morales, M., Grajeda, L. M., Lopez, M. R., McCraken, J. P., Cordón-Rosales, C., Palmer, G. H., Call, D. R., & Ramay, B. M. (2020). Availability of over-the-counter Antibiotics In Guatemalan Corner Stores. PLoS ONE, 15(9):6–11. https://doi.org/10.1371/journal.pone.0239873

Nohri, A. R., Siddiqui, M. I., Usman, G., Sarang, S., Memon, H. Q., Singh, D., & Kumar, S. (2024). Antibiotic Dispensation Without Prescription By Community Pharmacies in Pakistan. Journal of Medicine, Surgery, and Public Health, 2(December 2023):100065. https://doi.org/10.1016/j.glmedi.2024.100065

Salam, M. A., Al-Amin, M. Y., Salam, M. T., Pawar, J. S., Akhter, N., Rabaan, A. A., & Alqumber, M. A. A. (2023). Antimicrobial Resistance: A Growing Serious Threat for Global Public Health. Healthcare (Switzerland), 11(13). https://doi.org/10.3390/healthcare11131946

Santa-Ana-Tellez, Y., Mantel-Teeuwisse, A. K., Leufkens, H. G. M., & Wirtz, V. J. (2016). Effects of over-the-counter Sales Restriction Of Antibiotics On Substitution With Medicines For Symptoms Relief Of Cold In Mexico And Brazil: Time Series Analysis. Health Policy and Planning, 31(9):1291–1296. https://doi.org/10.1093/heapol/czw066

Tandjung, H., Wiyono, W. I., & Mpila, D. A. (2021). The Knowledge And Use Of Self - Medicated Antibiotics In The Community of Manado City. Pharmacon, 10(2):780–789.

Tang, K. W. K., Millar, B. C., & Moore, J. E. (2023). Antimicrobial Resistance (AMR). British Journal of Biomedical Science, 80(6):1–11. https://doi.org/10.3389/bjbs.2023.11387

Tufa, T. B., Regassa, F., Amenu, K., Stegeman, J. A., & Hogeveen, H. (2023). Livestock Producers’ Knowledge, Attitude, And Behavior (KAB) Regarding Antimicrobial Use In Ethiopia. Frontiers in Veterinary Science, 10:1–20. https://doi.org/10.3389/fvets.2023.1167847

Wall, S. (2019). Prevention of Antibiotic Resistance–An Epidemiological Scoping Review To Identify Research Categories And Knowledge Gaps. Global Health Action, 12(1):1–27. https://doi.org/10.1080/16549716.2020.1756191

World Health Organization. (2023). Antimicrobial Resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance

Wulandari, A., & Rahmawardany, C. Y. (2022). Perilaku Penggunaan Antibiotik di Masyarakat. Sainstech Farma, 15(1):9–16. https://doi.org/10.37277/sfj.v15i1.1105

Published
2025-09-28