Patterns of antimicrobial dispensing in community pharmacies in Russia during the COVID-19 pandemic

Objective. To evaluate the existing patterns of antimicrobials dispensing in community pharmacies during the COVID-19 pandemic. Materials and Methods. In a cross-sectional study conducted from October 2020 to January 2021 it was obtained the data on the major antimicrobials dispensing in community pharmacies in Moscow and four regions of Russian Federation: date of release, customer’s age and gender, drug name and formulation, the reason for the release (symptoms, preliminary or confirmed diagnosis), prescription-based supply or not/emergency releasing. Results. The study included 71 pharmacies, including 41 private and 30 public organizations. During the mentioned period of time 5514 antimicrobials were supplied to 5270 customers. Antibiotics and antiviral drugs for systemic use accounted the largest share in the structure of purchased antimicrobials (60.5% and 26.3% of all sales, respectively). The frequency of non-prescription-based supplies was 28.5%. The greatest demand among antibiotics was registered for macrolides (14.9%), combinations of penicillins with beta-lactamase inhibitors (12.3%) and fluoroquinolones (11.4%). Upper respiratory tract infections were the most frequent reason for antimicrobials releasing – 36,9%. COVID-19 was the reason for 8.4% of antimicrobials sales. Azithromycin and umifenovir were the most frequently used drugs for SARS-CoV-2. Conclusions. Antibiotics for systemic use have still remained the commonly used ones, whereas upper respiratory tract infections are the main indication for their purchase. Nearly a third of antimicrobials, including systemic antibiotics, were dispensed in private pharmacies without prescription. COVID-19 is uncommon cause of outpatient antimicrobial sales, but a common reason for systemic antibiotic prescribing.