City Research Online

Abstract

Background
We previously reported a cross-sectional analysis of online pharmacy practices and processes. Since then, the demand for and context of online healthcare has changed. However, the current state of access to and usage of antibiotics obtained online remains poorly understood.

Objectives
This study aimed to: (i) determine the legality of online pharmacies selling antibiotics in the UK; (ii) describe processes for obtaining antibiotics online; (iii) identify antimicrobial stewardship (AMS) and patient safety issues; and (iv) compare data with those obtained in 2016 to understand changes in context, and set priorities for targeted research in antibiotic access and usage.

Methods
Searches for ‘buy antibiotics online’ were conducted using ‘Google’ and ‘Yahoo’. The first 10 websites with unique URL addresses for each were reviewed. Analyses were conducted on evidence of pharmacy registration, prescription requirement, whether choice was ‘prescriber-driven’ or ‘consumer-driven’, and whether information was required (allergies, comorbidities, pregnancy) or given (adverse effects) prior to purchase.

Results
Twenty unique URL addresses were analysed. Those evidencing UK location (n = 20; 100%) required a prescription and were appropriately registered. For 11 (55%) online pharmacies, decisions were initially consumer-driven for antibiotic choice, but not for dose or duration; contrasting with 2016 when for most (n = 16; 80%), decisions were consumer-driven for antibiotic choice, dose and quantity.

Conclusions
Variation continues to exist in relation to antibiotic practices online. We make several key recommendations for lawmakers and stakeholders. Targeted research, improved public engagement, professional education and new best practice guidelines are urgently needed for online UK antibiotic suppliers.

Publication Type:	Article
Additional Information:	This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords:	antibiotics, internet, pharmacies, patient safety, online pharmacies
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RS Pharmacy and materia medica
Departments:	School of Health & Psychological Sciences School of Health & Psychological Sciences > Healthcare Services Research & Management
SWORD Depositor:	Symplectic Administrator

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