Current regulations in Spain state that antibiotics cannot be sold without a medical prescription. The objective of this study was to quantify the percentage of pharmacies selling antibiotics without an official medical prescription in Catalonia, Spain, by the simulation of 3 different clinical cases presented by actors. A prospective study was performed from January through May 2008. Three different cases were presented at pharmacies: sore throat, acute bronchitis, and a urinary tract infection. Three levels of demand were used to convince the pharmacists to sell an antibiotic. A total of 197 pharmacies were visited. Antibiotics were obtained from 55 (79.7%) of 69 pharmacies when a urinary tract infection was simulated, 24 (34.8%) of 69 pharmacies when a sore throat was simulated, and 10 (16.9%) of 59 pharmacies when acute bronchitis was simulated (P < .001). Among the pharmacies that sold antibiotics, the pharmacists provided an explanation as to the number of times per day the drug should be taken in 84.3%, explained the duration of treatment in 68.7%, and inquired about allergies prior to the sale of the antibiotic in only 16.9%. Of the 108 pharmacies that did not sell the antibiotics, only 57 (52.8%) explained that they could not be given over the counter for health care reasons or to avoid antibiotic resistance. These results demonstrate that, although illegal, the sale of antibiotics without a prescription continues in Spain. This should be taken into account by countries that are currently considering the possibility of making some antibiotics available over the counter.
