Knowledge, Attitude and Practice of Community Pharmacists in Relation to Dispensing Antibiotics Without Prescription in Sudan: A Cross-sectional Study

Abstract

Background Dispensing antibiotics without prescription (DAwP) is a widespread practice, especially in developing countries, contributing to antibiotic resistance. Community pharmacists play a significant role in promoting rational use of antibiotics by refraining from DAwP, and providing drug information to patients. This study aimed to evaluate community pharmacists’ knowledge, attitude and practice, and to assess the factors behind DAwP. Methods A cross-sectional study was conducted in 2020 among random sample of community pharmacists in Sudan. Online semi-structured questionnaire was used for data collection. The association between dependent and independent variables was assessed using Chi-square test; a P -value less than 0.05 was considered significant. Results Of the 1217 pharmacists who participated, the majority were female (n = 645, 53%). Most pharmacists have a B. Pharm degree (n = 1026, 84%) and less than 5 years’ experience (n = 718, 59%). Notably, the majority of community pharmacists have good knowledge (n = 735, 61.7%), which is significantly associated with years of experience (P < 0.00). More than half (n = 623, 52.2%) of the pharmacists have above average score of practice. Nearly all the pharmacists who participated have a positive attitude in relation to DAwP (n = 1204, 98.9%). More than half of the pharmacists were DAwP for tonsillitis (n = 817, 67%), wound infection (n = 766, 62.9%), and urinary tract infection (n = 664, 54%). The leading factor behind DAwP was the low socioeconomic status of the patients (n = 624, 51%). Additionally, 47% of the pharmacists (n = 572) thought that they were knowledgeable enough to DAwP. Conclusion Despite their positive attitude and average level of knowledge regarding DAwP, Sudanese community pharmacists frequently are DAwP for tonsillitis. Low patients’ socioeconomic status was the leading factor behind DAwP. Accordingly, extensive work from health authorities to improve the accessibility and affordability of the health system as well as the development of an antibiotic stewardship program are required to diminish DAwP.

Prevalence and Predictors of Antibiotic Self-Medication in Sudan: A Descriptive Cross-Sectional Study

“…Most of the antibiotics were purchased from pharmacies in several regions in Sudan [ 12 , 13 , 14 ]. This is compatible with the preceding report which revealed that more than 80% of the pharmacists in Sudan frequently dispense antibiotics without prescription [ 15 ].…”

Antibiotic Prescribing Pattern: Pharmacy Staff Knowledge about Antibiotics at Primary Health Care Centers in Riyadh City, Saudi Arabia

“…Furthermore, age, gender, and years of experience were not significant factors for the level of knowledge similar to previous studies with gender and differed with experiences. 13 It resembled others with age, gender, and experiences. 17 A different finding reported by a cross-sectional survey evaluated pharmacist knowledge in Sri Lanka, revealing that higher education is related to higher awareness of antibiotic resistance.…”

“…11 Such deficient knowledge is an issue locally and in other countries. 11 Half of the responders agreed to use broad-spectrum antibiotics, and the patient can stop antibiotics when reliving the symptoms; the percentage of responders similar to one study 13 lower than in a previous study, 17,24 because it might they implemented antibiotics guidelines or more antibiotics uses awareness available. When antibiotic therapy is to be used, it should be targeted to the pathogen as far as possible.…”

“…It might be the first pilot study done at the Primary Healthcare Center because most previous studies were conducted at hospitals or community pharmacies. [9][10][11][12][13][14][15][16][17] The reliability test was medium, related to a small sample of participants.…”

“…[9][10][11] However, evaluating pharmacist and pharmacy technician knowledge background of rational usages of antibiotics is rarely found locally. [12][13][14][15][16][17] The authors were unfamiliar with previous research on the current topics published earlier. The current research aims to determine the knowledge of the rational usage of antibiotics by pharmacy staff at primary healthcare centers in Saudi Arabia.…”