{"id":"https://openalex.org/W7225319476","doi":"https://doi.org/10.1038/s41598-026-79061-5","title":"Non-prescription antibiotic dispensing in community drug retail outlets in Central Gondar, Ethiopia: a mixed-methods study","display_name":"Non-prescription antibiotic dispensing in community drug retail outlets in Central Gondar, Ethiopia: a mixed-methods study","publication_year":2026,"publication_date":"2026-11-05","ids":{"openalex":"https://openalex.org/W7225319476","doi":"https://doi.org/10.1038/s41598-026-79061-5"},"language":"en","primary_location":{"id":"doi:10.1038/s41598-026-79061-5","doi":"https://doi.org/10.1038/s41598-026-79061-5","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41598-026-79061-5","pdf_url":"https://www.nature.com/articles/s41598-026-79061-5_reference.pdf","source":{"id":"https://openalex.org/S196734849","display_name":"Scientific Reports","issn_l":"2045-2322","issn":["2045-2322"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Scientific Reports","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.nature.com/articles/s41598-026-79061-5_reference.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5056834231","display_name":"Assefa Kebad Mengesha","orcid":"https://orcid.org/0000-0002-5998-0838","observed_orcids":["https://orcid.org/0000-0002-5998-0838"]},"institutions":[{"id":"https://openalex.org/I8764889","display_name":"University of Gondar","ror":"https://ror.org/0595gz585","country_code":"ET","type":"education","lineage":["https://openalex.org/I8764889"]}],"countries":["ET"],"is_corresponding":true,"raw_author_name":"Assefa Kebad Mengesha","raw_affiliation_strings":["Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia"],"raw_orcid":"https://orcid.org/0000-0002-5998-0838","affiliations":[{"raw_affiliation_string":"Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia","institution_ids":["https://openalex.org/I8764889"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160885364","display_name":"Sisay Tarekegn Gebyiaw","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I8764889","display_name":"University of Gondar","ror":"https://ror.org/0595gz585","country_code":"ET","type":"education","lineage":["https://openalex.org/I8764889"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Sisay Tarekegn Gebyiaw","raw_affiliation_strings":["Department of Pharmacology, Teda Health Science College, Gondar, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacology, Teda Health Science College, Gondar, Ethiopia","institution_ids":["https://openalex.org/I8764889"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5052077677","display_name":"Tewodros Ayalew Tessema","orcid":"https://orcid.org/0000-0002-5217-5510","observed_orcids":["https://orcid.org/0000-0002-5217-5510"]},"institutions":[{"id":"https://openalex.org/I8764889","display_name":"University of Gondar","ror":"https://ror.org/0595gz585","country_code":"ET","type":"education","lineage":["https://openalex.org/I8764889"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Tewodros Ayalew Tessema","raw_affiliation_strings":["Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia","institution_ids":["https://openalex.org/I8764889"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5056834231"],"corresponding_institution_ids":["https://openalex.org/I8764889"],"apc_list":{"value":2690,"currency":"USD","value_usd":2690},"apc_paid":{"value":2690,"currency":"USD","value_usd":2690},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13970","display_name":"Pharmacy and Medical Practices","score":0.000699999975040555,"subfield":{"id":"https://openalex.org/subfields/3611","display_name":"Pharmacy"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11649","display_name":"Pharmaceutical industry and healthcare","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2910","display_name":"Issues, ethics and legal aspects"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/antibiotic-misuse","display_name":"antibiotic misuse","score":0.3709999918937683},{"id":"https://openalex.org/keywords/licensed-pharmacists","display_name":"licensed pharmacists","score":0.6629999876022339},{"id":"https://openalex.org/keywords/ethiopia","display_name":"Ethiopia","score":0.3840000033378601},{"id":"https://openalex.org/keywords/amoxicillin","display_name":"amoxicillin","score":0.5600000023841858},{"id":"https://openalex.org/keywords/ciprofloxacin","display_name":"ciprofloxacin","score":0.9269999861717224},{"id":"https://openalex.org/keywords/metronidazole","display_name":"metronidazole","score":0.9900000095367432},{"id":"https://openalex.org/keywords/patient-counseling","display_name":"patient counseling","score":0.5680000185966492},{"id":"https://openalex.org/keywords/regulatory-enforcement","display_name":"regulatory enforcement","score":0.4009999930858612},{"id":"https://openalex.org/keywords/antimicrobial-resistance","display_name":"antimicrobial resistance","score":0.41999998688697815},{"id":"https://openalex.org/keywords/self-medication","display_name":"self-medication","score":0.4230000078678131}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7724000215530396},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.7060999870300293},{"id":"https://openalex.org/C501593827","wikidata":"https://www.wikidata.org/wiki/Q12187","display_name":"Antibiotics","level":2,"score":0.635200023651123},{"id":"https://openalex.org/C104863432","wikidata":"https://www.wikidata.org/wiki/Q614304","display_name":"Pharmacy","level":2,"score":0.6248000264167786},{"id":"https://openalex.org/C2426938","wikidata":"https://www.wikidata.org/wiki/Q3355478","display_name":"Medical prescription","level":2,"score":0.5993000268936157},{"id":"https://openalex.org/C2994493120","wikidata":"https://www.wikidata.org/wiki/Q13107184","display_name":"Community pharmacy","level":3,"score":0.5008999705314636},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.47049999237060547},{"id":"https://openalex.org/C2779708577","wikidata":"https://www.wikidata.org/wiki/Q201928","display_name":"Amoxicillin","level":3,"score":0.44600000977516174},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.44029998779296875},{"id":"https://openalex.org/C2777396551","wikidata":"https://www.wikidata.org/wiki/Q169569","display_name":"Metronidazole","level":3,"score":0.43529999256134033},{"id":"https://openalex.org/C2778512257","wikidata":"https://www.wikidata.org/wiki/Q256602","display_name":"Ciprofloxacin","level":3,"score":0.4000999927520752},{"id":"https://openalex.org/C2780035454","wikidata":"https://www.wikidata.org/wiki/Q8386","display_name":"Drug","level":2,"score":0.3555000126361847},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.32190001010894775},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.2987000048160553},{"id":"https://openalex.org/C2776012195","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory tract infections","level":3,"score":0.28940001130104065},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2775999903678894},{"id":"https://openalex.org/C23276603","wikidata":"https://www.wikidata.org/wiki/Q158230","display_name":"Pharmacoepidemiology","level":3,"score":0.2750000059604645},{"id":"https://openalex.org/C2993183539","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory infection","level":3,"score":0.2653000056743622},{"id":"https://openalex.org/C158739034","wikidata":"https://www.wikidata.org/wiki/Q1907114","display_name":"Metropolitan area","level":2,"score":0.2619999945163727},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.26159998774528503}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1038/s41598-026-79061-5","doi":"https://doi.org/10.1038/s41598-026-79061-5","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41598-026-79061-5","pdf_url":"https://www.nature.com/articles/s41598-026-79061-5_reference.pdf","source":{"id":"https://openalex.org/S196734849","display_name":"Scientific Reports","issn_l":"2045-2322","issn":["2045-2322"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Scientific Reports","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1038/s41598-026-79061-5","doi":"https://doi.org/10.1038/s41598-026-79061-5","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41598-026-79061-5","pdf_url":"https://www.nature.com/articles/s41598-026-79061-5_reference.pdf","source":{"id":"https://openalex.org/S196734849","display_name":"Scientific Reports","issn_l":"2045-2322","issn":["2045-2322"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Scientific Reports","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9907000064849854,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225319476.pdf","grobid_xml":"https://content.openalex.org/works/W7225319476.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4304091692","https://openalex.org/W2887089740","https://openalex.org/W3002801264","https://openalex.org/W7171081227","https://openalex.org/W6939302733","https://openalex.org/W2467502157","https://openalex.org/W4225159739","https://openalex.org/W7155504199","https://openalex.org/W7202078805","https://openalex.org/W4385396174"],"abstract_inverted_index":{"Antibiotics":[0,167],"are":[1],"prescription-only":[2],"medicines":[3],"in":[4,28,38,43,77,174,211,219,223,285,396,401],"Ethiopia,":[5,46],"yet":[6],"community":[7,39,82,397,412],"drug":[8,40,83,398],"retail":[9,41,84,399],"outlets":[10,42,153,400],"may":[11,52],"provide":[12],"an":[13,337],"important":[14],"route":[15],"of":[16,79,93,176,184,255,275,318,336,362],"access":[17],"without":[18,170],"a":[19,164,171,256,271,319],"valid":[20,172],"prescription.":[21],"Evidence":[22],"on":[23],"observed":[24,55,146,364,391,431],"non-prescription":[25,35,147,233],"antibiotic":[26,36,148,186,387],"dispensing":[27,37,56,234,388],"Central":[29,44,402],"Gondar":[30],"is":[31],"limited.":[32],"To":[33],"quantify":[34],"Gondar,":[45],"and":[47,117,131,135,203,253,287,316,378,381,411,429],"explore":[48],"contextual":[49],"factors":[50,143],"that":[51],"help":[53],"interpret":[54],"practices.":[57],"An":[58],"explanatory":[59],"sequential":[60],"mixed-methods":[61],"study":[62,424],"was":[63,160,217,235,268,389],"conducted":[64],"from":[65,291],"March":[66],"to":[67,141,289],"May":[68],"2024.":[69],"The":[70,119,280,330,404,423],"quantitative":[71],"component":[72,121],"used":[73,140,162,269],"standardized":[74,95,393],"simulated-client":[75,394],"encounters":[76,180,222,395],"120":[78,177],"134":[80],"eligible":[81],"outlets.":[85],"Each":[86],"outlet":[87,179,239,296],"received":[88],"one":[89,92],"encounter":[90],"involving":[91],"three":[94],"clinical":[96],"scenarios:":[97],"acute":[98],"uncomplicated":[99],"cough/upper":[100],"respiratory":[101],"symptoms,":[102],"non-bloody":[103],"diarrhea,":[104],"or":[105],"mild":[106],"urinary":[107],"symptoms.":[108],"A":[109,182],"structured":[110],"questionnaire":[111],"assessed":[112,178],"pharmacy":[113,128],"personnel\u2019s":[114],"knowledge,":[115],"attitudes,":[116],"perceptions.":[118],"qualitative":[120],"comprised":[122],"interviews":[123],"with":[124,145,237,354],"25":[125],"participants,":[126],"including":[127],"professionals,":[129],"clinicians,":[130],"regulatory":[132,375,407],"officials.":[133],"Bivariable":[134],"multivariable":[136,230],"logistic":[137,158,231,266],"regression":[138,159,267,357],"were":[139,154,168,188,226,283],"examine":[142],"associated":[144,236],"dispensing.":[149],"Because":[150],"only":[151],"29":[152],"outcome-negative,":[155],"Firth":[156,264,281,349],"penalized":[157,265],"additionally":[161],"as":[163,270,414,437],"sensitivity":[165,272],"analysis.":[166],"supplied":[169,189],"prescription":[173],"91":[175,192],"(75.8%).":[181],"total":[183],"116":[185],"items":[187],"during":[190,392],"these":[191],"encounters;":[193],"amoxicillin":[194],"accounted":[195],"for":[196,200,205,384,418],"49":[197],"(42.2%),":[198],"ciprofloxacin":[199],"26":[201],"(22.4%),":[202],"metronidazole":[204],"14":[206],"(12.1%).":[207],"Patient":[208],"assessment":[209],"occurred":[210],"24/120":[212],"(20.0%)":[213],"encounters,":[214],"while":[215],"counseling":[216],"provided":[218],"11/91":[220],"(12.1%)":[221],"which":[224],"antibiotics":[225],"supplied.":[227],"In":[228],"conventional":[229,293,356],"regression,":[232],"unlicensed":[238,295],"status":[240,297],"(AOR":[241,248,259,298,308,322,339],"3.45,":[242],"95%":[243,250,261,300,310,324,341],"CI":[244,251,262,301,311,325,342],"1.64\u20137.29),":[245],"peri-urban":[246,306],"location":[247,307],"2.21,":[249],"1.04\u20134.71),":[252],"absence":[254,317],"licensed":[257,320],"pharmacist":[258,321],"2.76,":[260],"1.32\u20135.74).":[263],"analysis":[273,350],"because":[274],"the":[276,292,348,355,360,363,367,430],"sparse":[277,368],"outcome-negative":[278,369],"category.":[279,370],"estimates":[282],"similar":[284],"magnitude":[286],"direction":[288],"those":[290],"model:":[294],"3.32,":[299],"1.55\u20137.25;":[302],"p":[303,313,327,344],"=":[304,314,328,345],"0.002),":[305],"2.16,":[309],"1.00\u20134.76;":[312],"0.050),":[315],"2.65,":[323],"1.24\u20135.67;":[326],"0.012).":[329],"fourth":[331],"covariate":[332],"showed":[333],"no":[334],"evidence":[335],"association":[338],"1.18,":[340],"0.56\u20132.49;":[343],"0.660).":[346],"Overall,":[347],"yielded":[351],"findings":[352,372,405],"consistent":[353],"model,":[358],"supporting":[359],"robustness":[361],"associations":[365,432],"despite":[366],"Qualitative":[371],"highlighted":[373],"perceived":[374],"challenges,":[376],"economic":[377],"competitive":[379],"pressures,":[380],"customer":[382],"expectations":[383,413],"antibiotics.":[385],"Non-prescription":[386],"frequently":[390],"Gondar.":[403],"identify":[406],"oversight,":[408],"professional":[409],"staffing,":[410],"potentially":[415],"relevant":[416],"areas":[417],"future":[419],"antimicrobial":[420],"stewardship":[421],"research.":[422],"did":[425],"not":[426,434],"evaluate":[427],"interventions,":[428],"should":[433],"be":[435],"interpreted":[436],"causal.":[438]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-11-06T00:00:00"}