Awareness, practices and perceptions of community pharmacists towards antimicrobial resistance and antimicrobial stewardship in Libya: a cross-sectional study

Abstract

Background Community pharmacists play a vital role in promoting appropriate use of antibiotics in the community. This study evaluated the practices and perceptions of community pharmacists towards antibiotic use, antibiotic resistance, and antimicrobial stewardship in Libya. Methods A cross-sectional study was conducted among community pharmacists in Libya using a 47-item validated, pre-tested online questionnaire. Data was collected from December 2021 to February 2022 and was analysed using descriptive and inferential analyses. Results Of the 114 questionnaires included in the analysis, 54.4% were females, 78.1% had < 10 year working experience (78.1%), and 81.6% had a Bachelor of Pharmacy. Most (78.1%) strongly agreed/agreed that community pharmacists have an important role to play to reduce antibiotic resistance. Overall, the participants had a moderate perception towards antimicrobial resistance (median score: 21.5; IQR [16–28] out of 35.0). More than 40% supply antibiotics when patients requested them specifically, because if they do not supply them, patients will just go to another pharmacy. About 47% strongly agreed/agreed that if a patient cannot afford a full course of antibiotics all in one go, they will give them a smaller amount that they are able to afford at that time, even when a longer duration of treatment is required. Most (66.7%) had no previous involvement in antibiotics awareness campaign due to ‘I have never heard about the campaign’ (48.7%) and ‘I do not have enough time to participate’ (22.4%). Overall, the perception towards antimicrobial stewardship was good (20 [13–25] out of 25.0). Raising awareness of rational antibiotic use, including antimicrobial resistance, among pharmacy students (83.4%) and patient education by pharmacists in community pharmacies at the time medicines are supplied to patients (81.6%) were the most common strategies to improve rational use of antibiotics in community pharmacy. Conclusions Community pharmacists in Libya recognise their role in reducing antimicrobial resistance. They had a moderate perception towards antimicrobial resistance and a good perception towards antimicrobial stewardship. However, inappropriate antibiotic practices were common. The most common strategies to improve rational use of antibiotics in community pharmacy were raising awareness about the rational antibiotic use among pharmacy students and patient education by community pharmacists at the time antibiotics are dispensed to patients. Regulations are needed to restrict dispensing antibiotics without prescription among community pharmacists.

Assessment of challenges and opportunities in antibiotic stewardship program implementation in Northwest Ethiopia

“…Almost similar results were reported from Black Lion Hospital with a slightly higher magnitude, where 82.4 % believed that ASP improves the quality of patient care, ASP reduces overall antibiotic consumption and can result in cost savings (76.9 %), ASP reduces the duration of hospital stay and associated costs (73.5 %), and ASP reduces the problem of AMR (82.9 %) [ 44 ]. In Libya, pharmacy professionals believed that ASP reduces the rate of AMR (70.2 %), reduces inappropriate use of antibiotics in the community (68.4 %), participation in ASP activities will boost public confidence in community pharmacy services (79 %), community pharmacists’ participation in the ASP will promote (73.7 %) and ASP activities are important in the hospital setting but are not important in the community setting (16.7 %) [ 78 ]. This assures that reducing AMR is a public health priority [ 58 ], and the implementation of ASP reduces inappropriate antibiotic use and AMR in hospital settings, in the community and private health facilities as well [ 4 , 51 , [78] , [79] , [80] ].…”

“…In Libya, pharmacy professionals believed that ASP reduces the rate of AMR (70.2 %), reduces inappropriate use of antibiotics in the community (68.4 %), participation in ASP activities will boost public confidence in community pharmacy services (79 %), community pharmacists’ participation in the ASP will promote (73.7 %) and ASP activities are important in the hospital setting but are not important in the community setting (16.7 %) [ 78 ]. This assures that reducing AMR is a public health priority [ 58 ], and the implementation of ASP reduces inappropriate antibiotic use and AMR in hospital settings, in the community and private health facilities as well [ 4 , 51 , [78] , [79] , [80] ].…”

Knowledge, Perception, and Self-Confidence of Antibiotic Resistance, Appropriate Antibiotic Therapy, and Antibiotic Stewardship Among Undergraduate Pharmacy Students in Sudan

“…31 A recent survey conducted in Libya presented a moderate perception of AMR among community pharmacists. 38 This disparity is attributed to varying experiential learning exposure and antibiotic knowledge levels among university students.…”

Antimicrobial Stewardship: Knowledge and Attitudes of Pharmacy Staff on Antibiotic Dispensing Patterns, Use and Resistance in Benin

“…Significant evidence has suggested that the knowledge and attitudes of pharmacy professionals and other healthcare workers (HCWs) can play a key role in managing the growing threat of AMR [35] [36] [37] [38]. This is because pharmacy professionals that have good knowledge and positive attitudes towards AMU and AMR usually promote good dispensing practices and rational use of antibiotics [39] [40] [41]. The occupation of pharmacy professionals is increasingly becoming patient-centered thereby making pharmacy professionals the most accessible HCWs [42] [43] [44].…”