Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia

Abstract

BackgroundIncreasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics. The objective of this study was to assess the perception and self-reported practices of community pharmacists towards antimicrobial stewardship.MethodsA cross-sectional study was conducted among community pharmacists between March–April, 2015, using a self-administered, pre-tested questionnaire in the State of Selangor, Malaysia. A simple random sampling approach was used to select pharmacy sites. Descriptive and inferential statistical methods were used to analyse the data.ResultsA total of 188 pharmacists responded to the survey, giving a response rate of 83.5%. The majority of participants (n = 182, 96.8%) believed that antimicrobial stewardship program helps healthcare professionals to improve the quality of patient care. However, more than half of pharmacists were neutral in their opinion about the incorporation of antimicrobial stewardship programs in community pharmacies (n = 102, 54.2%). Though collaboration was often done by pharmacists with other health professionals over the use of antibiotics (n = 104, 55.3%), a significant proportion of participants (n = 102, 54.2%) rarely/occasionally participate in antimicrobial awareness campaigns. Pharmacists having postgraduate qualification were more likely to held positive perceptions of, and were engaged in, antimicrobial stewardship than their non-postgraduate counterpart (p<0.05). Similarly, more experienced pharmacists (> 10 years) held positive perceptions towards antimicrobial stewardship (p<0.05).ConclusionThe study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized interventions would be critical to bridging these gaps and improve their perception and practices towards antimicrobial stewardship.

Veterinarians’ Perception, Knowledge and Practices of Antibiotic Stewardship in Enugu State Southeast, Nigeria

“…This finding is lower than the result (52.7%) of Khan et al (2016) among community pharmacists in Malaysia. It is very disturbing that more than one-third (35.4%) of the respondents perceived that ABS is aimed at increasing the use of broad-spectrum antibiotics.…”

“…The health and economic impact of ABR is enormous and dreadful, thus, veterinarians (as key healthcare providers) have been encouraged to hold the responsibility of ABS (principally targeted to reduce antibiotic use and development/spread of ABR) in practice area (Erku, 2016;Khan et al, 2016). The results obtained from this study have demonstrated that the overall level of awareness or knowledge about ABS amongst veterinarians in the study area is very poor (21.4%).…”

“…Therefore, it is crucial that ASPs that involve evidencebased guidelines, educational programmes and regular feedback of antibiotic usage data to veterinarians to promote rationale-based and evidence-based prescribing, be developed and established in Nigeria (Wickens et al, 2013;Burger et al, 2016). Increasing awareness of national ABR patterns and knowledge of latest treatment guidelines, are the important strategies that could be implemented as a part of veterinary ABS in the study area (Khan et al, 2016).…”

“…In European Union, the overall societal costs of ABR and complications arising from ABR were estimated to be €1.5-9 billion per year (Llor and Bjerrum, 2014;Cisneros et al, 2014) and an estimated mortality of 25,000 people annually (WHO, 2012;Scaioli et al, 2015). In United States, around 26,000 people die of multidrug-resistant bacterial infections each year (Spellberg et al, 2008;Khan et al, 2016), while 96,000 deaths are attributed to multidrug resistance in Southern Asia (Zaidi et al, 2004;Khan et al, 2016). Worldwide, it has been underestimated that about 700,000 lives are lost annually due to antimicrobial-resistant infections (O'Neil, 2014).…”

“…But for veterinarians to implement and help in achieving the goals of ABS, they (as healthcare providers/professionals), should be interested in and knowledgeable about ABR and ABS (Awad and Aboud, 2015;Guardabassi and Prescott, 2015;Coyne et al, 2016). Knowledge about ABS is critical for veterinarians because they are anticipated (as key healthcare providers) to take prominent roles in infection control programmes in healthcare (veterinary) systems and as educators of their clients/the public about ABR and ABS (Bowater, 2015;Khan et al, 2016). Therefore, assessing the veterinarians' perception and level of knowledge/awareness about ABS is crucial for identifying gaps in knowledge, development of effective ASPs and improvement of the curricula in Veterinary schools (Abbo et al, 2013;Paul and Gyssens, 2013;Cotta et al, 2014;Coyne et al, 2016).…”