Antibiotic leftovers in primary health care: an approach to economic impact and pharmaceutical care

Abstract

Objective: To evaluate the results of antibiotic dispensing in a Primary Health Care Unit in the municipality of São Paulo and to explore users’ knowledge regarding the use and disposal of antibiotics through pharmaceutical consultation. Method: A prospective, quantitative study was conducted between January and April 2024, through the analysis of oral antibiotic prescriptions and pharmaceutical consultations using a semi-structured questionnaire. Results: It was identified that 81.9% (n = 1,225) of 1,495 prescriptions resulted in leftover medication, generating a waste of 8,061 pharmaceutical units and an estimated financial loss of R$2,349.54. Among the 17 users interviewed, there was low knowledge about antimicrobial resistance, medication use and disposal. Only 29.4% (n = 5) returned the leftover medication after pharmaceutical intervention. Conclusion: Dispensing medication with leftovers encourages the improper use and disposal of antibiotics, contributing to antimicrobial resistance. Pharmaceutical care, within a multidisciplinary team approach, has the potential to reduce waste and promote rational use. We propose the implementation of unit-dose packaging protocols and educational initiatives for professionals and users.