{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:03:24Z","timestamp":1790229804144,"version":"4.1.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Data on sales of pharmaceutical products (SPP) for symptomatic treatment of acute respiratory diseases can be a reliable indicator providing initial information before official surveillance systems. This pilot study aimed to develop a framework for collecting community pharmacy sales data and assess the feasibility of using these data as a complementary indicator of respiratory infection activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Products were selected through observation of prime-time television advertisements during February\u2013March 2025, expert review, and a survey of 97 community pharmacists. Retrospective monthly sales data for selected product categories were obtained from two community pharmacies in Sofia for October 2024\u2013April 2025. Sales were analysed using descriptive statistics, the Friedman test, and post-hoc Wilcoxon signed-rank tests with Bonferroni correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean SPP vary from 121.06\u202funits for antivirals to 685.96\u202funits for antipyretics. Antivirals showed the greatest relative monthly variability (\n                      <jats:italic>R<\/jats:italic>\n                      \u202f=\u202f216.4, CV\u202f=\u202f64.78), followed by food supplements (\n                      <jats:italic>R<\/jats:italic>\n                      \u202f=\u202f160.16, CV\u202f=\u202f33.23). Sales of products for sore throat were comparatively stable (\n                      <jats:italic>R<\/jats:italic>\n                      \u202f=\u202f103, CV\u202f=\u202f18.62) with limited temporal variation during the observation period. Antipyretic and antiviral sales reached their highest levels in January 2025, accounting for 19.14 and 32.00% of their respective total sales during the observation period. The January increase temporally coincided with the peak in reported acute respiratory infections in Sofia during week 4 of 2025. However, pairwise comparisons between January and the other months were not statistically significant after Bonferroni correction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pharmacy sales data showed preliminary potential for monitoring local respiratory infection trends; however, larger prospective multicenter studies using standardized product classifications and higher-frequency sales data are needed to evaluate their contribution to complementary respiratory syndromic surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1886507","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:43:38Z","timestamp":1790228618000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of using community pharmacy sales of over-the-counter respiratory products as a syndromic surveillance indicator: a pilot study from Sofia, Bulgaria"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhivka","family":"Getsova","sequence":"first","affiliation":[{"name":"Epidemiology Department, National Centre of Infectious and Parasitic Diseases (NCIPD)","place":["Sofia, Bulgaria"]},{"name":"Center of Competence ImmunoPathogen","place":["Sofia, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanya","family":"Rangelova","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv","place":["Plovdiv, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venelin","family":"Sapunarov","sequence":"additional","affiliation":[{"name":"Regional Pharmaceutical College - Sofia Capital City","place":["Sofia, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Georgiev","sequence":"additional","affiliation":[{"name":"Epidemiology Department, National Centre of Infectious and Parasitic Diseases (NCIPD)","place":["Sofia, Bulgaria"]},{"name":"Center of Competence ImmunoPathogen","place":["Sofia, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalina","family":"Petkova","sequence":"additional","affiliation":[{"name":"Epidemiology Department, National Centre of Infectious and Parasitic Diseases (NCIPD)","place":["Sofia, Bulgaria"]},{"name":"Center of Competence ImmunoPathogen","place":["Sofia, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeri","family":"Tzekov","sequence":"additional","affiliation":[{"name":"Bulgarian Society for Innovative Medicine","place":["Plovdiv, Bulgaria"]},{"name":"Second Department of Internal Diseases, Section of Nephrology, Medical University of Plovdiv","place":["Plovdiv, Bulgaria"]},{"name":"First Dialysis Services Bulgaria\u2014Dialysis Center","place":["Plovdiv, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galin","family":"Kamenov","sequence":"additional","affiliation":[{"name":"Epidemiology Department, National Centre of Infectious and Parasitic Diseases (NCIPD)","place":["Sofia, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"ref1","volume-title":"International Health Regulations (2005)","year":"2008"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e234804","DOI":"10.1001\/jamahealthforum.2023.4804","article-title":"A historic moment in global health\u2014\u201cfutureproofing\u201d the world against pandemics","volume":"4","author":"Gostin","year":"2023","journal-title":"JAMA Health Forum"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e62641","DOI":"10.2196\/62641","article-title":"Early 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