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Objective. To evaluate the existing patterns of antimicrobials dispensing in community pharmacies during the COVID-19 pandemic. Materials and Methods. In a cross-sectional study conducted from October 2020 to January 2021 it was obtained the data on the major antimicrobials dispensing in community pharmacies in Moscow and four regions of Russian Federation: date of release, customer’s age and gender, drug name and formulation, the reason for the release (symptoms, preliminary or confirmed diagnosis), prescription-based supply or not/emergency releasing. Results. The study included 71 pharmacies, including 41 private and 30 public organizations. During the mentioned period of time 5514 antimicrobials were supplied to 5270 customers. Antibiotics and antiviral drugs for systemic use accounted the largest share in the structure of purchased antimicrobials (60.5% and 26.3% of all sales, respectively). The frequency of non-prescription-based supplies was 28.5%. The greatest demand among antibiotics was registered for macrolides (14.9%), combinations of penicillins with beta-lactamase inhibitors (12.3%) and fluoroquinolones (11.4%). Upper respiratory tract infections were the most frequent reason for antimicrobials releasing – 36,9%. COVID-19 was the reason for 8.4% of antimicrobials sales. Azithromycin and umifenovir were the most frequently used drugs for SARS-CoV-2. Conclusions. Antibiotics for systemic use have still remained the commonly used ones, whereas upper respiratory tract infections are the main indication for their purchase. Nearly a third of antimicrobials, including systemic antibiotics, were dispensed in private pharmacies without prescription. COVID-19 is uncommon cause of outpatient antimicrobial sales, but a common reason for systemic antibiotic prescribing.

COVID-19 has had a significant impact on health care systems, including drug use. The present study aimed to evaluate the patterns of community supply of antimicrobials from community pharmacies during the COVID-19 pandemic in five cities of Russia. In a cross-sectional study, a random sample of pharmacies reported all episodes of antimicrobials supply during a one-week period. Patterns of supply (age and gender of customer, drug name and formulation, prescription availability, indication, etc.) were analyzed. Altogether, 71 pharmacies took part in the study and 5270 encounters were recorded. In total, 4.2% of visits resulted in supply of more than one antimicrobial agent and 5.2% were for parenteral formulations. The rate of prescription-based purchase in participated cities varied from 40.5 to 99.1%. Systemic antibiotics and antivirals accounted for the majority of supplies (60.5 and 26.3%, respectively). Upper respiratory tract infections were reported as the indication for antimicrobials usage in 36.9% of cases, followed by skin and soft tissue infections (12.1%) and urinary tract infections (8.7%); COVID-19 accounted for 8.4% of all supplies. Amoxicillin with clavulanic acid, azithromycin and amoxicillin were indicated as the top three antimicrobials purchased for upper respiratory tract infections, and azithromycin, umifenovir and levofloxacin were the top three for COVID-19. In general, a high rate of drugs dispensing without prescription was revealed. Antibiotics for systemic use remained the most common antimicrobials, whereas presumably viral upper respiratory tract infections were the main reason for their purchase. COVID-19 infection itself was responsible for a small proportion of the supply of antimicrobial agents, but systemic antibiotics accounted for more than a half of supplies.