1670. Access to Antibiotics Without Prescription for Travelers and Colombian Citizens at Community Pharmacies in Bogotá, Colombia: A Cross-Sectional Study

Background Antimicrobial-resistant pathogens often emerge in communities where antibiotics are frequently sold without prescriptions. In Colombia, nonprescription sale of antibiotics still occurs despite national regulations. Use of antimicrobials in international travelers has been linked to the rapid dissemination of multidrug-resistant pathogens around the globe. Despite the exponential increase of international visitors to Colombia recently, there is a notable lack of studies investigating the accessibility of antibiotics to foreign travelers without prescriptions in Colombian pharmacies. Methods This cross-sectional study compares the access to antibiotics without prescription in community pharmacies between travelers from the United States and local Colombian citizens in Bogotá. Both groups visited 91 pharmacies and conducted trials as covert simulated clients (SCs). The SCs followed a standardized script when interacting with pharmacy personnel, acting as though they were seeking antibiotics for moderate Traveler’s Diarrhea (TD), without a prescription. Data were gathered on the employees’ responses, including the level of “prompting” needed for an employee to offer antibiotics, reasons given to the SCs for refusing to sell antibiotics if no sale was offered, and generic brand of compounds offered. Results Antibiotics were offered to the US travelers in 62 (68.13%) pharmacies, and to the Colombian group in 57 (62.64%) pharmacies. The traveler group was significantly more likely than the comparator group to be offered antibiotics without any prompting (P = 0.003). When pharmacy employees refused to sell antibiotics during trials, the traveler group was significantly more likely to be given a clinical reason not to receive antibiotics. Refusal to Colombian citizens was more frequently due legal reasons (P < 0.001). Conclusion Antibiotics were accessible without prescriptions at similarly high frequencies, regardless of the customers’ nationality. The US travelers were more likely than the Colombian group to be offered antibiotics without needing to prompt the pharmacist. Additionally, pharmacists were much more likely to deny antibiotics to the Colombian group due to legal reasons, as opposed to clinical reasons for US travelers. Disclosures All authors: No reported disclosures.