Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Knowledge, Attitude and Practice on Antibiotics and Its Resistance: Two Phases Mixed-Methods Online Study Among Pakistani Community Pharmacists to Promote Rational Antibiotics Use

Version 1 : Received: 1 January 2021 / Approved: 4 January 2021 / Online: 4 January 2021 (12:58:43 CET)

A peer-reviewed article of this Preprint also exists.

Khan, F.U.; Khan, F.U.; Hayat, K.; Ahmad, T.; Khan, A.; Chang, J.; Malik, U.R.; Khan, Z.; Lambojon, K.; Fang, Y. Knowledge, Attitude, and Practice on Antibiotics and Its Resistance: A Two-Phase Mixed-Methods Online Study among Pakistani Community Pharmacists to Promote Rational Antibiotic Use. Int. J. Environ. Res. Public Health 2021, 18, 1320. Khan, F.U.; Khan, F.U.; Hayat, K.; Ahmad, T.; Khan, A.; Chang, J.; Malik, U.R.; Khan, Z.; Lambojon, K.; Fang, Y. Knowledge, Attitude, and Practice on Antibiotics and Its Resistance: A Two-Phase Mixed-Methods Online Study among Pakistani Community Pharmacists to Promote Rational Antibiotic Use. Int. J. Environ. Res. Public Health 2021, 18, 1320.

Journal reference: Int. J. Environ. Res. Public Health 2021, 18, 1320
DOI: 10.3390/ijerph18031320

Abstract

Antibiotic resistance (ABR) is an emerging global threat to public health. Substantial evidence has indicated that community pharmacists (CPs) can play a critical role in managing the ever-increasing threat of antibiotic resistance. The study aimed to determine the knowledge, attitude, and practices of CPs (n=180) towards antibiotics and antibiotic resistance as well as to improve the rational use of antibiotics. Two phases of mixed methods (quantitative and qualitative) online study were conducted in Pakistan from August 2019 to March 2020 by using validated questionnaires and semi-structured interview data. Different statistical methods were used to tabulate the quantitative data whereas inductive thematic analysis was conducted to categorize themes from the qualitative data and draw conclusions. Approximately 64.4% were male (mean: 29-33 years old). Overall, CPs had good knowledge of and were familiar with superbugs and their roles in ABR (65.6%, Median=1, IQR=1) although they were poor in differentiating some antibiotic groups with their respective ABR patterns (31.1%, Median=1, IQR=1). Most CPs have a positive attitude towards antibiotics with most (90.0%) having identified ABR as a critical issue in public health (Median=1, IQR=0). Overall, CPs' practices towards antibiotics were reasonable where they tend to educate patients about the rational use of antibiotics (52.8%, Median=1, IQR=1). Two main themes (antibiotics and counseling of patients) were related to self-medication with while educational interventions are the sub-theme. ABR is multifactorial where the subthemes related to budget, time constraints incompetent staff, the absence of CPs, the lack of training, enforcement of laws and regulations are the need of the hour in Pakistan. Effective antibiotic stewardship programs, patient education, and awareness campaigns about antibiotics and ABR along with training of the CPs are important factors that have to be addressed in a timely manner.

Keywords

Antibiotics; antibiotic resistance; rational drug use; community pharmacist

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