The following article is Part 1 in a series dedicated to the issues and methodology surrounding the theme of properly dispensing of antibiotics.
A patient goes to the doctor for care for a disease requiring the use of an antibiotic. Assuming that the diagnosis at the time of visit required immediate treatment for a stated time as indicated in the directions of the prescription to the dispensing Pharmacists(Antibiotic act subsection 3 which states: Every person dispensing any such prescription shall comply with the following requirements:
- (a) the prescription shall not be dispensed otherwise than in accordance with the prescription, or more than once unless the prescription contains a direction in accordance with the provisions of paragraph (b);
- (b) if the prescription contains a direction that it may be dispensed a stated number of times or at stated intervals, it shall not be dispensed otherwise than in accordance with the direction).
It is assumed that:
- the intention was for the intervention to produce the desired outcome of the selected treatment within a given period. Pharmacists can refuse to fill a prescription after the period has expired without breaching the rights of the patient whose obligation it was to comply with the orders of the prescribing doctor. (The Patient’s Charter of Rights and Obligations-2.
- Compliance with Instructions states “You are responsible for following the plan of treatment recommended by the professional mainly responsible for your care. This can include following the instructions of nurses and other personnel associated with your care.”) If the date of issue and period of intended use have passed, filling of such a prescription may expose professionals and /or the institution for which they work to the risk of litigation. Objectively it can be viewed that a pharmacist may use his/her discretion in dispensing such a prescription where the period of treatment has lapsed.
However, this should be weighed against the risk of litigation as it brings the questions:
- What quantity is to be dispensed?
- Is the treatment still appropriate without consultation from the prescriber?
- Are the Pharmacists covered by the law to act in this manner?
Stay tuned for part 2 inthis series