Evaluating the Rationality of Antibiotic Dispensing in Treating Common Cold Infections among Pharmacists in Baghdad - Iraq

Background: Common cold is a self limited viral infection, which can be treated symptomatically without the need to antibiotics which are not effective or curative. This study aimed to evaluate the practices of community pharmacists in communicating, diagnosing, treating and counseling patients who are requesting antibiotics for their common cold treatment. Methods: A cross-sectional pilot exploratory study was done in Baghdad - Iraq at which a pharmacist acts as simulated person (SP) in order to collect the data. SP asks the pharmacist about the strongest antibiotic for common cold. SP observed and explored adherence of the pharmacist to law in dispensing over the counter (OTC) and prescription only medications (POM) drugs, patient's counseling standards, and symptomatic diagnosis of common cold through using WWHAM (who is the patient, what are the symptoms, for how long, any action taken, any medication taken) technique. Results: More than 60% of pharmacists had failed to use WWHAM technique as a method for probing information about the patient and his/her case history. Furthermore there is a significant lack for asking the patients about their past medical history and drug allergy. 45% of Iraqi pharmacists supplied the SP with antibiotic for his common cold. Amoxicillin was the most commonly supplied (44.4%) antibiotic for common cold. Patients' counseling by pharmacists was mostly about the frequency of drug dosing. Conclusion: There are insufficient clinical and communication skills for Iraqi pharmacists who work in community pharmacies, this result not only in an irrational antibiotic dispensing but also in poor pharmacist's ability to counsel and educate the patient about the proper use of the dispensed medications.