Abstract:
Background Convenience stores in Guatemala provide essential consumer goods in communities, but many dis‑
pense antibiotics illegally. Federal legislation, passed in August of 2019, requires prescriptions for antibiotic purchase
at pharmacies but it is unclear if this legislation is enforced or if it has any impact on unlawful sales of antibiotics.
Methods To determine if antibiotic availability changed in convenience stores, we carried out a repeated measures
study collecting antibiotic availability data before and after implementation of the dispensing regulation.
Results There was no statistical diference in the proportion of convenience stores that sold antibiotics
before and after antibiotic regulations [66.6% (295/443) and 66.7% (323/484), respectively, P>0.96], nor in the number
of stores selling amoxicillin [55.5% (246/443) and 52.3% (253/484), respectively, P>0.96], but fewer stores (20%) sold
tetracycline capsules after regulation was passed (P<0.05). For stores visited both before and after passage of legisla‑
tion (n=157), 15% stopped selling antibiotics while 25% started selling antibiotics. Antibiotics from convenience stores
were reportedly sold for use in people and animals.
Conclusions Antibiotics remain widely available in convenience stores consistent with no signifcant change
in the informal sector after implementation of prescription requirements for pharmacies. Importantly, efects
from regulatory change could have been masked by potential changes in antibiotic use during the Severe Acute
Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic.
