Introduction: There is considerable concern with rising rates of antimicrobial resistance (AMR) with its subsequent impact on morbidity,
mortality and costs. In low‑ and middle‑income countries, a key driver of AMR is the appreciable misuse of antibiotics in ambulatory care,
which can account for up to 95% of human utilisation. A principal area is the selling of antibiotics without a prescription. There is conflicting
evidence in South Africa regarding this practice alongside rising AMR rates. Consequently, there is a need to explore this further, especially
in more rural areas of South Africa. A pilot study was undertaken to address this. Materials and Methods: A two‑step descriptive approach
involving a self‑administered questionnaire amongst pharmacists and their assistants followed by cognitive interviews with some of the
participants. Results: Twenty‑one responses were obtained from nine of the 11 community pharmacies invited to participate. Participating
pharmacies were all independently owned. Ten of the 21 participants admitted dispensing antibiotics without a prescription, including both
adults and children, representing five of the nine participating pharmacies. A minority dispensed antibiotics before recommending suitable
over‑the‑counter medicines. These high rates were exacerbated by patient pressure. There were issues with the length of the questionnaire and
some of the phraseology, which will be addressed in the main study. Conclusion: There were concerns with the extent of purchasing antibiotics
without a prescription in this pilot in South Africa study. Key issues will be explored further in the main study.
