Table 4

Pharmacy responses to SPs

Total SP scenariosPresumptive TBMDR-TB
Frequency/proportion (%)Frequency/proportion (%)
N=318N=320
Medical history taken*
 No123 (38.7)75 (23.4)
 Yes195 (61.3)245 (76.6)
Referral to medical facility
 Total referrals (any of the following)39 (12.3)116 (36.3)
 To TB centre07 (2.2)57 (17.8)
 To private clinic12 (3.8)28 (8.8)
 To district healthcare centre/hospital31 (9.7)46 (14.4)
 Referral without giving antibiotics (subgroup of all aforementioned referrals)17 (5.3)68 (21.3)
Number of ‘all medications’ dispensed
 Median (IQR)5 (4–6)4 (0–5)
 0 (no other medicine dispensed)24 (7.5)86 (26.9)
 12 (0.6)1 (0.3)
 22 (0.6)4 (1.3)
 330 (9.4)23 (7.2)
 466 (20.8)64 (20.0)
 5105 (33.0)83 (25.9)
 ≥689 (27.9)59 (18.4)
Categories of medicines dispensed
 Number different types of medicines received in total1475 (100)1127 (100)
 Unlabelled medicines436 (29.6)311 (27.6)
 Antibiotics (general)244 (16.5)217 (19.3)
 Antibiotics (with anti-TB activity)14 (0.9)24 (2.1)
 Cough medicine230 (15.6)207 (18.4)
 Steroids/NSAIDS (anti-inflammatory)113 (7.7)107 (9.5)
 Antihistamines64 (4.3)51 (4.5)
 Pain/fever relief46 (3.1)16 (1.4)
 Vitamin supplementary70 (4.7)32 (2.8)
 Other identified medicine (bronchodilators, proton-pump inhibitors, etc)106 (7.2)81 (7.2)
 Any combined formulation (combination of cough and cold formulations that included antitussives, antihistamines and/or analgesics)152 (10.3)81 (7.2)
Class of antibiotic dispensed†N=258N=241
 Fluoroquinolones45 (17.4)39 (16.2)
 Broad-spectrum antibiotics other than fluoroquinolones202 (78.3)190 (78.8)
 Other antibiotic (includes lincomycins and unknown)11 (4.3)12 (5.0)
 Number of pharmacies sold one antibiotic238 (92.2)196 (78.7)
 Number of pharmacies sold two antibiotics20 (7.8)45 (18.7)
Prescription for an antibiotic requested by pharmacy staff
 No312 (98.1)212 (97.5)
 Yes6 (1.9)8 (2.5)
Antibiotic offered‡
 No32 (10.1)95 (29.7)
 Yes286 (89.9)225 (70.3)
Level of demand required to obtain antibioticN=286N=225
 Level 1 (Can I get some medicine to alleviate the symptoms?)
  Antibiotic given264 (92.3)218 (96.9)
  Antibiotic not given13 (7.7)7 (3.1)
 Level 2 (Can I get something stronger?)
  Antibiotic given13 (4.5)3 (1.3)
  Antibiotic not given9 (3.1)4 (1.8)
 Level 3 (I would like an antibiotic.)
  Antibiotic given9 (3.1)4 (1.8)
  Antibiotic not given00
  • *Possible history taken by staff in relation to reported symptoms.

  • †Actual antibiotics received after being verified by study pharmacists.

  • ‡Reported by standardised patient prior to verification by study pharmacists but not necessarily bought by SP due to several reasons (eg, no change cash notes available, told that antibiotics was dispensed but could not find these and vice versa, etc).

  • MDR-TB, multidrug-resistant tuberculosis; NSAID, non-steroidal anti-inflammatory drug; SP, standardised patient; TB, tuberculosis.