Antibiotics’ Use in Thailand: Community Pharmacists’ Knowledge, Attitudes and Practices

Abstract

Thailand spends $203 million on antibiotics every year, and patients can still access antimicrobials over the counter without a prescription. Community pharmacy plays a pivotal role in improving access and ensuring the appropriate use of antimicrobials. However, little is known about current practices in this setting. This study aims to assess Thai community pharmacists’ knowledge, attitudes and practices (KAP) regarding antimicrobials’ use and resistance. A cross-sectional study was conducted in Bangkok and Chonburi province in 2017 using an online self-administered questionnaire. The questionnaire was completed by 372 community pharmacists (71.4% response rate). The most commonly encountered infections in the community were upper and lower respiratory tract infections. The most commonly dispensed antimicrobials were broad-spectrum antibiotics including aminopenicillins and fluoroquinolones. Thai pharmacists have a good knowledge, attitude, and practice regarding antimicrobials’ use and resistance. They dispense anti-microbials in line with local guidelines, although international guidelines may not indicate anti-biotics for viral self-limiting infections. While community pharmacy in Thailand could be the most accessible healthcare resource for patients, inappropriate provision of antimicrobials for self-limiting viral infections by pharmacists will increase antimicrobial resistance. This highlights the need for updated guidance and improved pharmacists’ training.

Over-the-Counter Sale of Antibiotics in India: A Qualitative Study of Providers’ Perspectives across Two States

“…According to the WHO, over 50% of the antibiotic prescriptions worldwide are inappropriate with 2/3rds of antibiotics accessible at the pharmacies being used for self-medication [ 14 ] and the easy over-the-counter (OTC) access to antibiotics, which is common in LMIC’s [ 15 ]. There are a few recent reports showing that pharmacists dispensed antibiotics without prescriptions or that consumers visit pharmacies to buy antibiotics as OTC medicine, e.g., in Bangladesh [ 16 ], China [ 17 ], Mozambique [ 18 ], Thailand [ 19 ], and India [ 20 ]. Thus, self-medication and easy access to antibiotics without a prescription is one of the major concerns for the inappropriate and overuse of antibiotics in the community.…”

Antibiotic Resistance (Abr) and Community Pharmacist: A Review

“…Proper disease diagnosis and the rational selection of antibiotics are crucial [3] When symptoms have only been present for two days, or less treatment is generally not recommended as certain bacterial infections are self-limiting [13]. Antibiotic use has increased by 36% globally between 2000 and 2010 in countries including Brazil, Russia, India, China, and South Africa [14,15]. According to a recent WHO multicountry survey, 93% of people self-medicate with antibiotics obtained from a community pharmacy [16].…”

Antimicrobial Resistance and Community Pharmacists’ Perspective in Thailand: A Mixed Methods Survey Using Appreciative Inquiry Theory

“…Therefore, the first ASU programme was set to focus on pharyngitis, being a common infectious disease that led to the community pharmacists dispensing antibiotics. It has been established that clinical practices are informed by one’s knowledge and attitudes [ 37 , 38 , 39 , 40 , 41 ]. Thus, it is crucial to evaluate community pharmacists’ knowledge of antibiotic resistance and the underlying attitudes that determine their antibiotic dispensing behaviour to further explore the main reasons behind their antibiotic prescribing practices [ 42 ].…”