Chang J, Xu S, Zhu S, et al. - Researchers sought to determine non-prescription distributing of antibiotics cross-sectionally at community pharmacies in China in 2017, and longitudinally (2011–17) in a single province. Non-prescription antibiotic distribution was assessed using a simulated client method based on scenarios about pediatric diarrhea and adult acute upper respiratory tract infection (URTI), which were presented at each pharmacy. From 221 counties or districts in six provinces in different regions of China, cross-sectional data for 2,423 community pharmacies were collected in 2017. Further, 213 community pharmacies in Shaanxi province were assessed with a baseline survey in 2011 and subsequent follow-up surveys every 2 years until 2017. They recognized non-prescription antibiotic dispensing during 1,169 (48·5%) of 2,411 diarrhea interactions and 1,690 (70·1%) of 2,411 adult URTI interactions. Rural areas and the central and western provinces had a higher prevalence of non-prescription antibiotic dispensing. They observed a negative correlation of the presence of a pharmacist on-site and being part of a chain pharmacy with non-prescription antibiotic dispensing. They observed significant decreases of non-prescription antibiotic dispensing in pediatric cases and adult cases, between 2011 and 2017, in Shaanxi province. Findings thereby suggest a notable prevalence of non-prescription dispensing of antibiotics at community pharmacies nationwide in China in 2017. This emphasizes the necessity for multifaceted measures, including regulatory interventions, professional training, and public health education.