Background: Pharmacists are considered gatekeepers to antibiotic use by the European Centre for Disease Prevention and Control, but little is known about daily practice in community pharmacies.
Objectives: To describe antibiotic dispensing practices of community pharmacists in France, Greece, Lithuania, Poland, and Spain.
Methods: The Audit Project Odense methodology was used for self-registration of antibiotic dispensing practices. Community pharmacists registered all dispenses of oral antibiotics for humans for five days in February 2022.
Results: In total, 104 pharmacists registered 2498 dispensings. Amoxicillin (24.9%) and amoxicillin + clavulanic acid (18.7%) were dispensed most often. In 24% of the dispenses, the location of infection was unknown, most often in Poland (41.8%) and least often in Spain (12.0%). For 31.6% of the dispenses none of three safety checks (interactions, contraindications, allergies) were performed. Not performing safety checks happened most often in Lithuania, Poland, and Spain (41.6%, 41.6% and 40.3% respectively) and least in France and Greece (13.1% and 10.7% respectively). Pharmacists advised on treatment duration and dose in more than 80% of cases. Other advice was given rarely. Although pharmacists did not agree or did not have sufficient information to agree with antibiotic prescriptions in 24.4% of cases, there was only contact with prescribers in 2.4%.
Conclusions: Community pharmacists in the five EU countries do not seem to meet European guidelines regarding antibiotic dispensing and minimum requirements to fulfil their gatekeeper role are not met. Although stronger collaboration between pharmacist and prescriber is essential, many improvements can come from the community pharmacy level.
