Knowledge, Attitudes, and Practices of Community Pharmacy Professionals on Poultry Antibiotic Dispensing, Use, and Bacterial Antimicrobial Resistance in Zambia: Implications on Antibiotic Stewardship and WHO AWaRe Classification of Antibiotics

Abstract

Globally, the inappropriate dispensing and use of antibiotics in animals has contributed to the development of bacterial antimicrobial resistance (AMR). In Zambia, there is insufficient information among community pharmacy professionals on antibiotic use (ABU) and AMR in food-producing animals. This study assessed community pharmacy professionals’ knowledge, attitudes, and practices regarding poultry antibiotic dispensing, use, and bacterial AMR in the Lusaka district of Zambia. A cross-sectional study was conducted among 178 community pharmacy professionals between February and April 2022 using a semi-structured questionnaire. Data were analyzed using Stata version 17. Of the total participants (n = 178), 51.1% (n = 91) were pharmacists. The most dispensed antibiotic was oxytetracycline, a Watch antibiotic, mainly without prescriptions. Good knowledge of ABU and AMR was associated with work experience for more than one year (p = 0.016), while good practices were associated with male gender (p = 0.039) and work experience of more than one year (p = 0.011). The study found moderate knowledge, positive attitudes, and moderate practices of pharmacy professionals on poultry ABU and AMR. There was high dispensing of poultry antibiotics without prescriptions, which calls for strict implementation of antimicrobial stewardship and surveillance programs in poultry production in Zambia to reduce AMR.

Evaluation of Healthcare Students’ Knowledge on Antibiotic Use, Antimicrobial Resistance and Antimicrobial Stewardship Programs and Associated Factors in a Tertiary University in Ghana: Findings and Implications

“…A total score ≥ 60% for knowledge on antibiotic use, AMR, and ASP was considered as good based on similar studies [ 46 , 60 , 62 ]. We are aware other studies have used lower and higher cut-off scores up to 80% for good knowledge [ 53 , 94 , 95 ]. However, we chose ≥ 60% based on previous published studies [ 46 , 60 , 62 ].…”

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

“…However, this study only involved South Africa among the African countries in its analysis, with currently very limited self-purchasing of antibiotics in South Africa with strict regulations [ 28 , 29 ]. There is also appreciable consumption of antibiotics in agricultural and farming sectors across Africa, often with antibiotics of concern, adding selection pressure for AMR [ 30 , 31 , 32 , 33 ]. This is leading to increasing calls for a One Health approach across Africa, coupled with measures to prohibit the self-purchasing of antibiotics to reduce future AMR [ 34 , 35 , 36 , 37 ].…”

Antibiotic Use and Stewardship Indicators in the First- and Second-Level Hospitals in Zambia: Findings and Implications for the Future

“…This includes a multisectoral national Antimicrobial Resistance Coordinating Committee (AMRCC) on AMR. Ongoing activities across Zambia also include documenting current antimicrobial use in hospitals, the prescribing of antibiotics in ambulatory care, the procurement of antibiotics without a prescription, and extensive veterinary use, including among poultry farmers, given the potential for AMR with their overuse [ 13 , 14 , 15 , 16 ]. There have also been concerns with the management of patients with community-acquired pneumonia in hospitals in Zambia with high mortality rates, enhanced by high co-morbidity rates of the human immunodeficiency virus (HIV) and tuberculosis (TB) among patients [ 17 ].…”