Antiprotozoal dispensing patterns in South Africa, with the focus on antimalarial medicines

Abstract

The primary aim was to determine the dispensing patterns of antimalarial medicine in a community pharmacy patient population in South Africa. A retrospective, cross-sectional drug utilisation study was conducted on a 2013 pharmacy database. Medicines reimbursed by private medical aid schemes and private purchases were included. Records for antiprotozoals (ATC group P01) were extracted, with the focus on antimalarials. A total of 140132 antiprotozoal products were dispensed. Most products (67.28%) were for agents against amoebiasis and other protozoal diseases, followed by antimalarials (31.54%). A total of 19121 patients were prescribed 44191 antimalarial products. The average age of patients was 49.81 (SD=15.64) years. Half of the antimalarial products dispensed were for chloroquine (49.39%), followed by mefloquine (19.32%), the combination of atovaquone and proguanil (19.21%) and quinine (11.09%). Other active ingredients were artemether in combination with lumefantrine (386 products), the combination of sulfadoxine and pyrimethamine, halofantrine hydrochloride and pyrimethamine. Most products were prescription-only medicines. There was an increase in the number of products dispensed from July to December, that is, towards the warmer months in South Africa. Gauteng, the Western Cape and KwaZulu-Natal had the highest number of products dispensed. Chloroquine accounted for half of antimalarial medicines. However, chloroquine has dual usage for malaria and rheumatoid arthritis, and the high chloroquine prescribing rate may therefore not only reflect malaria prescriptions. The study provided baseline information on antimalarial dispensing patterns and emphasised the importance of diagnoses in drug utilization research.

Keywords: Malaria, antiprotozoal, drug utilisation, prescribing patterns, South Africa