Comparative analysis of the unregulated sale of antimicrobial prescription medication by drug retailers before and during the COVID-19 pandemic in Abuja, Nigeria

Abstract

Background: The sustained high-level unregulated sale of prescription medicines in developing countries is recognized as a significant factor in the development of drug resistance among pathogenic microorganisms. Apart from the millions of deaths annually that are attributed directly to antimicrobial resistance to commonly prescribed medicines this major global public health problem hinders achieving the United Nations’ Sustainable Development Goals by its target of 2030. This study compared the extent of the sale of non-prescribed antimalarial medication and of antibiotics before and during the coronavirus disease (COVID)-19 pandemic in each of the six local government areas within the Federal Capital Territory-Abuja, Nigeria. Methods: A structured questionnaire was designed to determine the percentage sales of both antimalarials and antibiotics, without diagnosis or prescription from qualified medical practitioners, over six-month periods between January to June of 2019 and 2020. Results: The data showed that all of the 130 community pharmacies and registered chemist stores where questionnaires were completed engaged in non-prescribed sales of both sets of medicine. Moreover, approximately three-quarters of drug retailers recorded increased patronage in the purchase of both classes of antimicrobial during the 2020 survey period that coincided with the first few months of the COVID-19 pandemic. Over successive years this saw an overall rise in over-the-counter sales of antimalarials and antibiotics (each p < 0.01). Yet, only Abuja Municipal Area Council and Bwari (p<0.0001 and p <0.001, respectively) recorded significant increases in indiscriminate sales of each medicine. Conclusion: In line with the high frequency of self-medication, this report points to the threat of possible emergence and spread of multidrug-resistant bacterial and Plasmodium spp. in the Abuja region. These findings highlight the imperative requirement for public health policymakers to implement effective strategies to curb the extensive unregulated sale of prescription drugs in the nation’s capital city and likely elsewhere in Nigeria.