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No more antibiotics without a doctor's prescription

Antimicrobial resistance is a global public health challenge with serious implications to patient health outcomes and enormous added costs to national health systems. The development of antibiotic resistance is directly linked to the scale and manner of antibiotic consumption.

Recent data show that antibiotics are not only overly consumed in Greece but also that the rates of antibiotic resistance are consistently higher than other EU member states. Greece and Italy have the highest levels of morbidity and number of deaths associated with antibiotic-resistant infections. And while the judicious use of antibiotics is considered critical in halting the development of antibiotic resistance, Greece still ranks 1st in the consumption of antibiotics within primary healthcare settings, among other EU member states. Greece is also far ahead of Romania, which ranks 2nd.

The use of antibiotics without a doctor's prescription is forbidden in Greece for the last three decades, (since 1973, as per Law (ΦΕΚ) 172 / 8.8.1973). But the situation is rather different in practice. In a study conducted in 2010 which showcased the true magnitude of the availability of over-the-counter antibiotics, 21 researchers went to 174 pharmacies across Greece and asked for 2 antibiotics without providing neither a doctor's prescription or any other explanation to the pharmacist. Out of every visit to a pharmacy (100% of the time), researchers were sold at least one antibiotic. A second antibiotic, which in this case was ciprofloxacin and which has been labelled as prescription-only since 2003 in Greece, was sold to researchers just over half of the time (53% of instances). The latter finding, showed that though the 2003 law limiting the prescription of some antibiotics may have managed to reduce prescription at the pharmacy 5 years later, it had yet to completely eliminate the phenomenon.

It is important to remember that the use of antibiotics is not without consequences for patients. Antibiotics should only be administered upon specific indications and upon a doctor’s prescriptions. Today, should new laws be developed against over the counter prescribing and these are also imposed, then Greece can stand a chance to limit resistance and stop being the champion in a race where the winner should come last.

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Center for Clinical Epidemiology and Outcomes Research (CLEO) was founded thanks to a grant from the Stavros Niarchos Foundation, which from 2011 until today continues to support its operation as a major donor.

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