In 2019, we visited 28 street markets in Port-au-Prince (Haiti) and bought 258 packs containing antibiotics. Once in the laboratory, we analyzed the content of the pills and capsules included in these packs by using a Raman handheld spectrometer (NanoRAM of BWTEK, Model: BWS456-785). Only for three out of 11 antimicrobials (Amoxicillin, Metronidazole, and Cotrimoxazole) had a good or acceptable quality for more than 95% of their tablets/capsules. But it should be highlighted that for six antimicrobials (Tetracycline, Erythromycin, Cloxacillin, Azithromycin, Clarithromycin, and the combination Amoxicillin + Clavulanic Acid) none of their tablets/capsules showed a sufficient quality as compared with the authentic medicine. This findings indicate that the products sold in the markets did not contain the labelled drug and/or contained a degraded drug. So, patients taking them will not be cured in many cases and, what is worst, could be taking other medicines not appropriate for their condition. Finally, this situation could contribute to the growing threat of resistance to antibiotics.
In many street markets, medicines are freely sold. This pilot study can help other researchers in many countries to easily highlight this problem in their markets, thus contributing to design campaigns to improve this situation.
Counterfeit and substandard medicines are quite common in many countries. Unfortunately, it is a widespread problem, and it is difficult to fight against it. This quite simple method could be useful because this can allow identifying the importance of the problem in countries with informal street markets.Albert Figueras, MD, PhD
Antibiotics 2020, 9(7), 407