Covid-19 Research

Research Article

Knowledge, Attitude, and Practices of Community Pharmacists on Antibiotic Resistance and Antimicrobial Stewardship in Lusaka, Zambia

Journal of Biomedical Research & Environmental Sciences article abstract with citation details, DOI, publication dates, subject areas, full text links, and references.

View DOI Submit Manuscript

Article Details

Publication record, authors, dates, abstract, and full text access.

Open Access
Article Type Research Article
Subject General Science
OCLC 9331581520
Steward Mudenda*, Mutinta Hankombo, Zikria Saleem, Mohammad Jaffar Sadiq, Michelo Banda, Derick Munkombwe, Chiluba Mwila, Maisa Kasanga, Annie Chibwe Zulu, Jimmy Mapenzi Hangoma, Webrod Mufwambi, Lungwani Tyson Muungo, Ronald Mutati Kampamba, Andrew Munkuli Bambala, Noor Mohammed Abdulrahman, Muhammad Akram, Christabel Nangu2019andu Hikaambo and John Bwalya Muma
Issue: Volume2-Issue10
Pages: 1005-1014
Received: 2021-10-21
Accepted: 2021-10-29
Published: 2021-10-30

Abstract

Background: Antimicrobial/Antibiotic Resistance (AMR) is among the major threats to global health. Due to limited information on the subject matter in Zambia, we assessed the knowledge, attitude, and practices of community pharmacists on AMR and Antimicrobial Stewardship (AMS).

Materials and Methods: We conducted a descriptive cross-sectional study among 144 randomly selected community pharmacists through a structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22 at a 95% confidence level. The Fisher’s exact test was used to determine the relationship between sociodemographic factors of community pharmacists and their knowledge, attitude, and practices on antibiotic resistance and antimicrobial stewardship.

Results: A response rate of 91% (n = 144) was achieved. Interestingly, 93.8% had good knowledge while 67% had positive attitudes regarding AMR and AMS. Conversely, 75% of the community pharmacists demonstrated poor practices towards AMR and AMS. The majority of the CPs 69.4% agreed that antibiotic resistance is a public health problem. The majority of the CPs 57.6% agreed that the appropriate use of antibiotics improves patient care and outcome. Of concern, (32.6%) of CPs rarely collaborated with other healthcare workers in activities that promote infection control and AMS. Also, the majority of the CPs did not take part in antibiotic awareness campaigns nor educate the public on antibiotic use and over 80% of CPs regularly issued antibiotics without a prescription.

Conclusions: Even though community pharmacists had good knowledge and positive attitudes, they demonstrated poor practices that require quick educational interventions. As most CPs issue antibiotics without a prescription, this should be highlighted as a major policy issue on AMR and should be addressed by the Government. There is a need to promote AMS sensitization programmes among community pharmacists.

FullText HTML FullText PDF DOI: 10.37871/jbres1343 Crossmark

Certificate of Publication

Certificate of Publication

Copyright

© 2021 Mudenda S, et al. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Mudenda S, Hankombo M, Saleem Z, Sadiq MJ, Banda M, Munkombwe D, Mwila C, Kasanga M, Zulu AC, Hangoma JM, Mufwambi W, Muungo LT, Kampamba RM, Bambala AM, Abdulrahman NM, Akram M, Hikaambo CN, Muma JB. Knowledge, Attitude, and Practices of Community Pharmacists on Antibiotic Resistance and Antimicrobial Stewardship in Lusaka, Zambia. J Biomed Res Environ Sci. 2021 Oct 30; 2(10): 1005-1014. doi: 10.37871/jbres1343, Article ID: JBRES1343, Available at: https://www.jelsciences.com/articles/jbres1343.pdf

Subject area(s)

Community Health

University/Institute

University of Zambia

References

  1. Conly J, Johnston B. Where are all the new antibiotics? The new antibiotic paradox. Can J Infect Dis Med Microbiol. 2005 May;16(3):159-60. doi: 10.1155/2005/892058. PMID: 18159536; PMCID: PMC2095020.
  2. Gottlieb T, Nimmo GR. Antibiotic resistance is an emerging threat to public health: an urgent call to action at the Antimicrobial Resistance Summit 2011. Med J Aust. 2011 Mar 21;194(6):281-3. doi: 10.5694/j.1326-5377.2011.tb02973.x. PMID: 21426279.
  3. Collignon PJ, McEwen SA. One Health-Its Importance in Helping to Better Control Antimicrobial Resistance. Trop Med Infect Dis. 2019 Jan 29;4(1):22. doi: 10.3390/tropicalmed4010022. PMID: 30700019; PMCID: PMC6473376.
  4. Jinks T, Lee N, Sharland M, Rex J, Gertler N, Diver M, Jones I, Jones K, Mathewson S, Chiara F, Farrar J. A time for action: antimicrobial resistance needs global response. Bull World Health Organ. 2016 Aug 1;94(8):558-558A. doi: 10.2471/BLT.16.181743. PMID: 27516629; PMCID: PMC4969997.
  5. Friedman ND, Temkin E, Carmeli Y. The negative impact of antibiotic resistance. Clin Microbiol Infect. 2016 May;22(5):416-22. doi: 10.1016/j.cmi.2015.12.002. Epub 2015 Dec 17. PMID: 26706614.
  6. Sabtu N, Enoch DA, Brown NM. Antibiotic resistance: what, why, where, when and how? Br Med Bull. 2015;116:105-13. doi: 10.1093/bmb/ldv041. Epub 2015 Oct 21. PMID: 26491083.
  7. Franco BE, Altagracia Martínez M, Sánchez Rodríguez MA, Wertheimer AI. The determinants of the antibiotic resistance process. Infect Drug Resist. 2009;2:1-11. Epub 2009 Apr 17. PMID: 21694883; PMCID: PMC3108730.
  8. Saleem Z, Saeed H, Ahmad M, Yousaf M, Hassan HB, Javed A, Anees N, Maharjan S. Antibiotic Self-Prescribing Trends, Experiences and Attitudes in Upper Respiratory Tract Infection among Pharmacy and Non-Pharmacy Students: A Study from Lahore. PLoS One. 2016 Feb 26;11(2):e0149929. doi: 10.1371/journal.pone.0149929. PMID: 26919465; PMCID: PMC4769098.
  9. Kotwani A, Holloway K. Antibiotic prescribing practice for acute, uncomplicated respiratory tract infections in primary care settings in New Delhi, India. Trop Med Int Health. 2014 Jul;19(7):761-8. doi: 10.1111/tmi.12327. Epub 2014 Apr 22. PMID: 24750565.
  10. Tyrstrup M, Melander E, Hedin K, Beckman A, Mölstad S. Children with respiratory tract infections in Swedish primary care; prevalence of antibiotic resistance in common respiratory tract pathogens and relation to antibiotic consumption. BMC Infect Dis. 2017 Sep 4;17(1):603. doi: 10.1186/s12879-017-2703-3. PMID: 28870173; PMCID: PMC5583975.
  11. Hsu J. How covid-19 is accelerating the threat of antimicrobial resistance. BMJ. 2020 May 18;369:m1983. doi: 10.1136/bmj.m1983. PMID: 32423901.
  12. Mudenda S. Letter to Editor: Coronavirus Disease (COVID-19): A Global Health Problem. Int J Pharm Pharmacol. 2020;4(1):141.
  13. Reardon S. Antibiotic treatment for covid-19 complications could fuel resistant bacteria. Science 2020.
  14. https://bit.ly/3nxCmvq
  15. Phiri MN, Banda M, Mudenda S, Ngazimbi M, Hangoma J, Mufwambi W et al. Coronavirus Disease 2019 (COVID-19): the role of pharmacists in the Fight against COVID-19 Pandemic. Int J Pharm Pharmacol. 2020;4(1):143.
  16. Godman B, Haque M, McKimm J, Abu Bakar M, Sneddon J, Wale J, Campbell S, Martin AP, Hoxha I, Abilova V, Anand Paramadhas BD, Mpinda-Joseph P, Matome M, de Lemos LLP, Sefah I, Kurdi A, Opanga S, Jakupi A, Saleem Z, Hassali MA, Kibuule D, Fadare J, Bochenek T, Rothe C, Furst J, Markovic-Pekovic V, Bojanić L, Schellack N, Meyer JC, Matsebula Z, Phuong TNT, Thanh BN, Jan S, Kalungia A, Mtapuri-Zinyowera S, Sartelli M, Hill R. Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future. Curr Med Res Opin. 2020 Feb;36(2):301-327. doi: 10.1080/03007995.2019.1700947. Epub 2019 Dec 30. PMID: 31794332.
  17. Adepu R, Nagavi BG. General practitioner’s perceptions about the extended roles of the community pharmacist in the state of Karnataka: A study. Indian J Pharm Sci. 2006;68(1):36-40. doi: 10.4103/0250-474X.22961
  18. Ahmad A, Atique S, Balkrishnan R, Patel I. Pharmacy profession in India: Current scenario and Recommendations. Ind. J Pharm Edu Res. 2014;48:12-15.
  19. https://bit.ly/3vTAbpQ
  20. Sharma H, Jindal D, Aqil M, Alam M, Karim S, Kapur P. A survey for assessment of the role of the pharmacist in community pharmacy services. J. Pharm. Bioallied Sci. 2009;1:23.
  21. https://bit.ly/3CqbW5d
  22. Hoa NB, Tiemersma EW, Sy DN, Nhung NV, Vree M, Borgdorff MW, Cobelens FG. Health-seeking behaviour among adults with prolonged cough in Vietnam. Trop Med Int Health. 2011 Oct;16(10):1260-7. doi: 10.1111/j.1365-3156.2011.02823.x. Epub 2011 Jun 22. PMID: 21692960.
  23. Yegenoglu S, Ozcelikay G. Counseling of pharmacists to community on issues other than drug purchasing and drug-related information: a survey in Ankara. Turkish J Pharm Sci. 2005;2(2):83-91.
  24. https://bit.ly/3EqW6bc
  25. Rutter P. Role of community pharmacists in patients' self-care and self-medication. Integr Pharm Res Pract. 2015 Jun 24;4:57-65. doi: 10.2147/IPRP.S70403. PMID: 29354520; PMCID: PMC5741028.
  26. Awad AI, Aboud EA. Knowledge, attitude and practice towards antibiotic use among the public in Kuwait. PLoS One. 2015 Feb 12;10(2):e0117910. doi: 10.1371/journal.pone.0117910. PMID: 25675405; PMCID: PMC4326422.
  27. Saleem Z, Hassali MA, Godman B, Fatima M, Ahmad Z, Sajid A, Rehman IU, Nadeem MU, Javaid Z, Malik M, Hussain A. Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study. J Pharm Policy Pract. 2020 Aug 3;13:26. doi: 10.1186/s40545-020-00233-3. PMID: 32774870; PMCID: PMC7397594.
  28. Marković-Peković V, Grubiša N. Self-medication with antibiotics in the Republic of Srpska community pharmacies: pharmacy staff behavior. Pharmacoepidemiol Drug Saf. 2012 Oct;21(10):1130-3. doi: 10.1002/pds.3218. Epub 2012 Feb 15. PMID: 22334375.
  29. Sadasivam K, Chinnasami B, Ramraj B, Karthick N, Saravanan A. Knowledge, Attitude and Practice of Paramedical staff towards antibiotic usage and its resistance. Integerrima Barberry. Biomed Pharmacol J. 2016;9(1):337-343. doi: 10.13005/bpj/944
  30. Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. Lancet Infect Dis. 2011 Sep;11(9):692-701. doi: 10.1016/S1473-3099(11)70054-8. Epub 2011 Jun 12. PMID: 21659004; PMCID: PMC3543997.
  31. Al-Faham Z, Habboub G, Takriti F. The sale of antibiotics without prescription in pharmacies in Damascus, Syria. J Infect Dev Ctries. 2011 May 28;5(5):396-9. doi: 10.3855/jidc.1248. PMID: 21628818.
  32. Alabid AH, Ibrahim MI, Hassali MA. Antibiotics Dispensing for URTIs by Community Pharmacists (CPs) and General Medical Practitioners in Penang, Malaysia: A Comparative Study using Simulated Patients (SPs). J Clin Diagn Res. 2014 Jan;8(1):119-23. doi: 10.7860/JCDR/2014/6199.3923. Epub 2014 Jan 12. PMID: 24596741; PMCID: PMC3939520.
  33. Saleem Z, Hassali MA, Hashmi FK. Pakistan's national action plan for antimicrobial resistance: translating ideas into reality. Lancet Infect Dis. 2018 Oct;18(10):1066-1067. doi: 10.1016/S1473-3099(18)30516-4. PMID: 30303099.
  34. Waseem H, Ali J, Sarwar F, Khan A, Rehman HSU, Choudri M, Arif N, Subhan M, Saleem AR, Jamal A, Ali MI. Assessment of knowledge and attitude trends towards antimicrobial resistance (AMR) among the community members, pharmacists/pharmacy owners and physicians in district Sialkot, Pakistan. Antimicrob Resist Infect Control. 2019 Apr 24;8:67. doi: 10.1186/s13756-019-0517-3. PMID: 31049196; PMCID: PMC6482541.
  35. Melton BL, Lai Z. Review of community pharmacy services: what is being performed, and where are the opportunities for improvement? Integr Pharm Res Pract. 2017 Mar 6;6:79-89. doi: 10.2147/IPRP.S107612. PMID: 29354554; PMCID: PMC5774328.
  36. Chuc NT, Larsson M, Do NT, Diwan VK, Tomson GB, Falkenberg T. Improving private pharmacy practice: a multi-intervention experiment in Hanoi, Vietnam. J Clin Epidemiol. 2002 Nov;55(11):1148-55. doi: 10.1016/s0895-4356(02)00458-4. PMID: 12507680.
  37. Sarwar MR, Saqib A, Iftikhar S, Sadiq T. Knowledge of community pharmacists about antibiotics, and their perceptions and practices regarding antimicrobial stewardship: a cross-sectional study in Punjab, Pakistan. Infect Drug Resist. 2018 Jan 18;11:133-145. doi: 10.2147/IDR.S148102. PMID: 29403295; PMCID: PMC5783150.
  38. Saleem Z, Hassali MA, Hashmi FK, Godman B, Saleem F. Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan. Fam Med Community Health. 2019 Jul 12;7(3):e000138. doi: 10.1136/fmch-2019-000138. PMID: 32148717; PMCID: PMC6910752.
  39. Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, Srinivasan A, Dellit TH, Falck-Ytter YT, Fishman NO, Hamilton CW, Jenkins TC, Lipsett PA, Malani PN, May LS, Moran GJ, Neuhauser MM, Newland JG, Ohl CA, Samore MH, Seo SK, Trivedi KK. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016 May 15;62(10):e51-77. doi: 10.1093/cid/ciw118. Epub 2016 Apr 13. PMID: 27080992; PMCID: PMC5006285.
  40. Gilchrist M, Wade P, Ashiru-Oredope D, Howard P, Sneddon J, Whitney L, Wickens H. Antimicrobial Stewardship from Policy to Practice: Experiences from UK Antimicrobial Pharmacists. Infect Dis Ther. 2015 Sep;4(Suppl 1):51-64. doi: 10.1007/s40121-015-0080-z. Epub 2015 Sep 11. PMID: 26362295; PMCID: PMC4569645.
  41. Erku DA, Aberra SY. Non-prescribed sale of antibiotics for acute childhood diarrhea and upper respiratory tract infection in community pharmacies: a 2 phase mixed-methods study. Antimicrob Resist Infect Control. 2018 Jul 31;7:92. doi: 10.1186/s13756-018-0389-y. Erratum in: Antimicrob Resist Infect Control. 2019 Jan 11;8:10. PMID: 30079248; PMCID: PMC6069571.
  42. Bishop C, Yacoob Z, Knobloch MJ, Safdar N. Community pharmacy interventions to improve antibiotic stewardship and implications for pharmacy education: A narrative overview. Res Social Adm Pharm. 2019 Jun;15(6):627-631. doi: 10.1016/j.sapharm.2018.09.017. Epub 2018 Sep 26. PMID: 30279131.
  43. Essack S, Bell J, Shephard A. Community pharmacists-Leaders for antibiotic stewardship in respiratory tract infection. J Clin Pharm Ther. 2018 Apr;43(2):302-307. doi: 10.1111/jcpt.12650. Epub 2017 Dec 4. PMID: 29205419.
  44. Brink AJ, Messina AP, Feldman C, Richards GA, Becker PJ, Goff DA, Bauer KA, Nathwani D, van den Bergh D; Netcare Antimicrobial Stewardship Study Alliance. Antimicrobial stewardship across 47 South African hospitals: an implementation study. Lancet Infect Dis. 2016 Sep;16(9):1017-1025. doi: 10.1016/S1473-3099(16)30012-3. Epub 2016 Jun 14. PMID: 27312577.
  45. Saha SK, Barton C, Promite S, Mazza D. Knowledge, Perceptions and Practices of Community Pharmacists Towards Antimicrobial Stewardship: A Systematic Scoping Review. Antibiotics (Basel). 2019 Dec 12;8(4):263. doi: 10.3390/antibiotics8040263. PMID: 31842511; PMCID: PMC6963969.
  46. Spellberg B, Guidos R, Gilbert D, Bradley J, Boucher HW, Scheld WM, Bartlett JG, Edwards J Jr; Infectious Diseases Society of America. The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Clin Infect Dis. 2008 Jan 15;46(2):155-64. doi: 10.1086/524891. PMID: 18171244.
  47. Atif M, Asghar S, Mushtaq I, Malik I. Community pharmacists as antibiotic stewards: A qualitative study exploring the current status of Antibiotic Stewardship Program in Bahawalpur, Pakistan. J Infect Public Health. 2020 Jan;13(1):118-124. doi: 10.1016/j.jiph.2019.07.003. Epub 2019 Sep 20. PMID: 31548165.
  48. Avent ML, Fejzic J, van Driel ML. An underutilised resource for Antimicrobial Stewardship: a 'snapshot' of the community pharmacists' role in delayed or 'wait and see' antibiotic prescribing. Int J Pharm Pract. 2018 Aug;26(4):373-375. doi: 10.1111/ijpp.12431. Epub 2018 Jan 10. PMID: 29318696.
  49. Zambia Medicines Regulatory Authority (ZAMRA). 2019.
  50. Guilford JP, Fruchter B. Fundamental statistics in psychology and education. New York: McGraw-Hill; 1973.
  51. https://bit.ly/2XTVL0U
  52. Mudenda S, Bangara FF, Sitali J, Banda M. Knowledge, attitude, and practices on antibiotic resistance among Pharmacists at the University Teaching hospitals in Lusaka, Zambia. Journal of Harmonized Research in Pharmacy. 2019;8:12-24.
  53. https://bit.ly/3EpLIjH
  54. Gebretekle GB, Serbessa MK. Exploration of over the counter sales of antibiotics in community pharmacies of Addis Ababa, Ethiopia: pharmacy professionals' perspective. Antimicrob Resist Infect Control. 2016 Jan 29;5:2. doi: 10.1186/s13756-016-0101-z. PMID: 26835006; PMCID: PMC4734870.
  55. Saengcharoen W, Chongsuvivatwong V, Lerkiatbundit S, Wongpoowarak P. Factors influencing dispensing of antibiotics for upper respiratory infections among Southern Thai community pharmacists. J Clin Pharm Ther. 2008 Apr;33(2):123-9. doi: 10.1111/j.1365-2710.2007.00890.x. PMID: 18315777.
  56. Zawahir S, Lekamwasam S, Aslani P. A cross-sectional national survey of community pharmacy staff: Knowledge and antibiotic provision. PLoS One. 2019 Apr 25;14(4):e0215484. doi: 10.1371/journal.pone.0215484. PMID: 31022197; PMCID: PMC6483176..
  57. Dillip A, Embrey M, Shekalaghe E, Ross-Degnan D, Vialle-Valentin C, Kimatta S, Liana J, Rutta E, Valimba R, Chalker J. What motivates antibiotic dispensing in accredited drug dispensing outlets in Tanzania? A qualitative study. Antimicrob Resist Infect Control. 2015 Jul 21;4:30. doi: 10.1186/s13756-015-0073-4. PMID: 26199723; PMCID: PMC4509560.
  58. Zakaa El-Din M, Samy F, Mohamed A, Hamdy F, Yasser S, Ehab M. Egyptian community pharmacists' attitudes and practices towards antibiotic dispensing and antibiotic resistance; a cross-sectional survey in Greater Cairo. Curr Med Res Opin. 2019 Jun;35(6):939-946. doi: 10.1080/03007995.2018.1544119. Epub 2018 Dec 4. PMID: 30388895.
  59. Jamshed S, Padzil F, Shamsudin SH, Bux SH, Jamaluddin AA, Bhagavathula AS, Azhar S, Hassali MA. Antibiotic Stewardship in Community Pharmacies: A Scoping Review. Pharmacy (Basel). 2018 Aug 23;6(3):92. doi: 10.3390/pharmacy6030092. PMID: 30142902; PMCID: PMC6163858.
  60. Apisarnthanarak A, Tunpornchai J, Tanawitt K, Mundy LM. Nonjudicious dispensing of antibiotics by drug stores in Pratumthani, Thailand. Infect Control Hosp Epidemiol. 2008 Jun;29(6):572-5. doi: 10.1086/587496. PMID: 18510468.
  61. Muñoz EB, Dorado MF, Guerrero JE, Martínez FM. The effect of an educational intervention to improve patient antibiotic adherence during dispensing in a community pharmacy. Aten Primaria. 2014 Aug-Sep;46(7):367-75. doi: 10.1016/j.aprim.2013.12.003. Epub 2014 Feb 26. PMID: 24581680; PMCID: PMC6983631.
  62. Ghiga I, Stålsby Lundborg C. 'Struggling to be a defender of health' -a qualitative study on the pharmacists' perceptions of their role in antibiotic consumption and antibiotic resistance in Romania. J Pharm Policy Pract. 2016 Mar 31;9:10. doi: 10.1186/s40545-016-0061-y. PMID: 27042313; PMCID: PMC4818418.
  63. Zapata-Cachafeiro M, González-González C, Váquez-Lago JM, López-Vázquez P, López-Durán A, Smyth E, Figueiras A. Determinants of antibiotic dispensing without a medical prescription: A cross-sectional study in the north of Spain. J. Antimicrob. Chemother. 2014; 69:3156-3160.
  64. Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015 Apr;40(4):277-83. PMID: 25859123; PMCID: PMC4378521.
  65. Roque F, Soares S, Breitenfeld L, Figueiras A, Herdeiro MT. Influence of community pharmacists׳ attitudes on antibiotic dispensing behavior: a cross-sectional study in Portugal. Clin Ther. 2015 Jan 1;37(1):168-77. doi: 10.1016/j.clinthera.2014.11.006. Epub 2014 Dec 4. PMID: 25482306.
  66. Dooling KL, Kandeel A, Hicks LA, El-Shoubary W, Fawzi K, Kandeel Y, Etman A, Lohiniva AL, Talaat M. Understanding Antibiotic Use in Minya District, Egypt: Physician and Pharmacist Prescribing and the Factors Influencing Their Practices. Antibiotics (Basel). 2014 Jun 20;3(2):233-43. doi: 10.3390/antibiotics3020233. PMID: 27025746; PMCID: PMC4790392.
  67. Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20(4):373-80. doi: 10.2478/v10001-007-0038-9. PMID: 18165197.
  68. Ameko E, Achio S, Alhassan S. Effects of Antibiotic Self-Medication on the Efficacy of Four Antibiotics Commonly used in Ghana on Clinically Isolated Microorganisms. Int J Pure Appl Sci Technol. 2012;10:62-70.
  69. Haddadin RN, Alsous M, Wazaify M, Tahaineh L. Evaluation of antibiotic dispensing practice in community pharmacies in Jordan: A cross sectional study. PLoS One. 2019 Apr 29;14(4):e0216115. doi: 10.1371/journal.pone.0216115. PMID: 31034528; PMCID: PMC6488076.
  70. O’Neill J. The Review on Antimicrobial Resistance. Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. 2016.
  71. https://bit.ly/2ZvHnwv
  72. Goossens H. Antibiotic consumption and link to resistance. Clin Microbiol Infect. 2009 Apr;15 Suppl 3:12-5. doi: 10.1111/j.1469-0691.2009.02725.x. PMID: 19366364.
  73. Wojkowska-Mach J, Godman B, Glassman A, Kurdi A, Pilc A, Rozanska A, Skoczyński S, Wałaszek M, Bochenek T. Antibiotic consumption and antimicrobial resistance in Poland; findings and implications. Antimicrob Resist Infect Control. 2018 Nov 15;7:136. doi: 10.1186/s13756-018-0428-8. PMID: 30473786; PMCID: PMC6238284.
  74. Kardas P, Devine S, Golembesky A, Roberts C. A systematic review and meta-analysis of misuse of antibiotic therapies in the community. Int J Antimicrob Agents. 2005 Aug;26(2):106-13. doi: 10.1016/j.ijantimicag.2005.04.017. PMID: 16009535.
  75. Godman B, Fadare J, Kibuule D, et al. Initiatives across countries to reduce antibiotic utilisation and resistance patterns: impact and implications. In: Arora G, Sajid A, Kalia VC, editors. Drug resistance in bacteria, fungi, malaria, and cancer. Cham: Springer International Publishing; 2017. p.539-576.
  76. https://bit.ly/3BpP1Wg
  77. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, Vlieghe E, Hara GL, Gould IM, Goossens H, Greko C, So AD, Bigdeli M, Tomson G, Woodhouse W, Ombaka E, Peralta AQ, Qamar FN, Mir F, Kariuki S, Bhutta ZA, Coates A, Bergstrom R, Wright GD, Brown ED, Cars O. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013 Dec;13(12):1057-98. doi: 10.1016/S1473-3099(13)70318-9. Epub 2013 Nov 17. Erratum in: Lancet Infect Dis. 2014 Jan;14(1):11. Erratum in: Lancet Infect Dis. 2014 Mar;14(3):182. PMID: 24252483.
  78. Abdelaziz AI, Tawfik AG, Rabie KA, Omran M, Hussein M, Abou-Ali A, Ahmed AF. Quality of Community Pharmacy Practice in Antibiotic Self-Medication Encounters: A Simulated Patient Study in Upper Egypt. Antibiotics (Basel). 2019 Apr 1;8(2):35. doi: 10.3390/antibiotics8020035. PMID: 30939797; PMCID: PMC6627069.
  79. World Health Organisation (WHO). Factsheet: Antimicrobial resistance. 2017.
  80. Leung E, Weil DE, Raviglione M, Nakatani H; World Health Organization World Health Day Antimicrobial Resistance Technical Working Group. The WHO policy package to combat antimicrobial resistance. Bull World Health Organ. 2011 May 1;89(5):390-2. doi: 10.2471/BLT.11.088435. PMID: 21556308; PMCID: PMC3089396.
  81. Roque F, Soares S, Breitenfeld L, López-Durán A, Figueiras A, Herdeiro MT. Attitudes of community pharmacists to antibiotic dispensing and microbial resistance: a qualitative study in Portugal. Int J Clin Pharm. 2013 Jun;35(3):417-24. doi: 10.1007/s11096-013-9753-4. Epub 2013 Feb 9. PMID: 23397322.
  82. Mansour O, Al-Kayali R. Community Pharmacistsꞌ Role in Controlling Bacterial Antibiotic Resistance in Aleppo, Syria. Iran J Pharm Res. 2017 Fall;16(4):1612-1620. PMID: 29552070; PMCID: PMC5843323.
  83. Gajdács M, Paulik E, Szabó A. Knowledge, Attitude and Practice of Community Pharmacists Regarding Antibiotic Use and Infectious Diseases: A Cross-Sectional Survey in Hungary (KAPPhA-HU). Antibiotics (Basel). 2020 Jan 21;9(2):41. doi: 10.3390/antibiotics9020041. PMID: 31973119; PMCID: PMC7168197.
  84. Machowska A, Stålsby Lundborg C. Drivers of Irrational Use of Antibiotics in Europe. Int J Environ Res Public Health. 2018 Dec 23;16(1):27. doi: 10.3390/ijerph16010027. PMID: 30583571; PMCID: PMC6338985.
  85. Hanafi S, Poormalek F, Torkamandi H, Hajimiri M, Esmaeili M, Khooie S, Gholami K, Hayatshahi A, Javadi M. Evaluation of Community Pharmacists’ Knowledge, Attitude and Practice towards Good Pharmacy Practice in Iran. J Pharm Care. 2013;1(1):19-24.
  86. https://bit.ly/3vTwII2
  87. Marković-Peković V, Grubiša N, Burger J, Bojanić L, Godman B. Initiatives to Reduce Nonprescription Sales and Dispensing of Antibiotics: Findings and Implications. J Res Pharm Pract. 2017 Apr-Jun;6(2):120-125. doi: 10.4103/jrpp.JRPP_17_12. PMID: 28616436; PMCID: PMC5463547.
  88. Hayat K, Rosenthal M, Gillani AH, Chang J, Ji W, Yang C, Jiang M, Zhao M, Fang Y. Perspective of Key Healthcare Professionals on Antimicrobial Resistance and Stewardship Programs: A Multicenter Cross-Sectional Study From Pakistan. Front Pharmacol. 2020 Jan 10;10:1520. doi: 10.3389/fphar.2019.01520. PMID: 31998124; PMCID: PMC6967405.
  89. Erku DA. Antimicrobial Stewardship: A Cross-Sectional Survey Assessing the Perceptions and Practices of Community Pharmacists in Ethiopia. Interdiscip Perspect Infect Dis. 2016;2016:5686752. doi: 10.1155/2016/5686752. Epub 2016 Nov 22. PMID: 27994621; PMCID: PMC5138470.
  90. Vazquez-Lago J, Gonzalez-Gonzalez C, Zapata-Cachafeiro M, Lopez-Vazquez P, Taracido M, López A, Figueiras A. Knowledge, attitudes, perceptions and habits towards antibiotics dispensed without medical prescription: a qualitative study of Spanish pharmacists. BMJ Open. 2017 Oct 8;7(10):e015674. doi: 10.1136/bmjopen-2016-015674. PMID: 28993379; PMCID: PMC5640063.
  91. Hoxha I, Malaj A, Kraja B, Bino S, Oluka M, Marković-Peković V, Godman B. Are pharmacists' good knowledge and awareness on antibiotics taken for granted? The situation in Albania and future implications across countries. J Glob Antimicrob Resist. 2018 Jun;13:240-245. doi: 10.1016/j.jgar.2018.01.019. Epub 2018 Feb 4. PMID: 29414723.
  92. Horumpende PG, Sonda TB, van Zwetselaar M, Antony ML, Tenu FF, Mwanziva CE, Shao ER, Mshana SE, Mmbaga BT, Chilongola JO. Prescription and non-prescription antibiotic dispensing practices in part I and part II pharmacies in Moshi Municipality, Kilimanjaro Region in Tanzania: A simulated clients approach. PLoS One. 2018 Nov 21;13(11):e0207465. doi: 10.1371/journal.pone.0207465. PMID: 30462700; PMCID: PMC6248976.
  93. Dameh M, Norris P, Green J. New Zealand pharmacists' experiences, practices and views regarding antibiotic use without prescription. J Prim Health Care. 2012 Jun 1;4(2):131-40. PMID: 22675697.
  94. Nasrin D, Collignon PJ, Roberts L, Wilson EJ, Pilotto LS, Douglas RM. Effect of beta lactam antibiotic use in children on pneumococcal resistance to penicillin: prospective cohort study. BMJ. 2002 Jan 5;324(7328):28-30. doi: 10.1136/bmj.324.7328.28. PMID: 11777803; PMCID: PMC61657.
  95. Costa FA, Scullin C, Al-Taani G, Hawwa AF, Anderson C, Bezverhni Z, Binakaj Z, Cordina M, Foulon V, Garcia de Bikuña B, de Gier H, Granås AG, Grinstova O, Griese-Mammen N, Grincevicius J, Grinceviciene S, Kaae S, Kubiliene L, Mariño EL, Martins S, Modamio P, Nadin G, Nørgaard LS, Obarcanin E, Tadic I, Tasic L, McElnay JC, Hersberger KE, Westerlund T. Provision of pharmaceutical care by community pharmacists across Europe: Is it developing and spreading? J Eval Clin Pract. 2017 Dec;23(6):1336-1347. doi: 10.1111/jep.12783. Epub 2017 Aug 1. PMID: 28762651.
  96. Kennie-Kaulbach N, Farrell B, Ward N, Johnston S, Gubbels A, Eguale T, Dolovich L, Jorgenson D, Waite N, Winslade N. Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies. BMC Fam Pract. 2012 Mar 28;13:27. doi: 10.1186/1471-2296-13-27. PMID: 22455482; PMCID: PMC3372430.
  97. Hayat K, Li P, Rosenthal M, Xu S, Chang J, Gillani AH, Khan FU, Sarwar MR, Ji S, Shi L, Cheng A, Fang Y. Perspective of community pharmacists about community-based antimicrobial stewardship programs. A multicenter cross-sectional study from China. Expert Rev Anti Infect Ther. 2019 Dec;17(12):1043-1050. doi: 10.1080/14787210.2019.1692655. Epub 2019 Nov 18. PMID: 31714841.
  98. Drew RH. Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm. 2009 Mar;15(2 Suppl):S18-23. doi: 10.18553/jmcp.2009.15.s2.18. PMID: 19236137.
  99. Klepser ME, Adams AJ, Klepser DG. Antimicrobial stewardship in outpatient settings: leveraging innovative physician-pharmacist collaborations to reduce antibiotic resistance. Health Secur. 2015 May-Jun;13(3):166-73. doi: 10.1089/hs.2014.0083. PMID: 26042860.
  100. Tegagn GT, Yadesa TM, Ahmed Y. Knowledge, Attitudes and Practices of Healthcare Professionals towards Antimicrobial Stewardship and Their Predictors in Fitche Hospital. J Bioanal Biomed. 2017;9:091-097. doi: 10.4172/1948-593X.1000159
  101. Saha SK, Hawes L, Mazza D. Effectiveness of interventions involving pharmacists on antibiotic prescribing by general practitioners: a systematic review and meta-analysis. J Antimicrob Chemother. 2019 May 1;74(5):1173-1181. doi: 10.1093/jac/dky572. PMID: 30698721.
  102. Howard P, Ashiru-Oredope D, Gilchrist M. Time for pharmacy to unite in the fight against antimicrobial resistance. Organ. 2014;18:08.
  103. Schellack N, Bronkhorst E, Coetzee R, Godman B, Gous AGS, Kolman S, Labuschagne Q, Malan L, Messina AP, Naested C, Schellack G, Skosana P, Van Jaarsveld A. SASOCP position statement on the pharmacist’s role in antibiotic stewardship 2018. South African J Infect Dis. 2018;33(1):28-35. doi: 10.4102/sajid.v33i1.24
  104. Brink AJ, Messina AP, Feldman C, Richards GA, Becker PJ, Goff DA, Bauer KA, Nathwani D, van den Bergh D; Netcare Antimicrobial Stewardship Study Alliance. Antimicrobial stewardship across 47 South African hospitals: an implementation study. Lancet Infect Dis. 2016 Sep;16(9):1017-1025. doi: 10.1016/S1473-3099(16)30012-3. Epub 2016 Jun 14. PMID: 27312577.
  105. Khan MU, Hassali MA, Ahmad A, Elkalmi RM, Zaidi ST, Dhingra S. Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia. PLoS One. 2016 Feb 22;11(2):e0149623. doi: 10.1371/journal.pone.0149623. PMID: 26901404; PMCID: PMC4764324.
  106. Cotta MO, Robertson MS, Tacey M, et al. Attitudes towards antimicrobial stewardship: results from a large private hospital in Australia. Healthc Infect. 2014;19(3):89-94. doi: 10.1071/HI14008.
  107. PGEU statement Community pharmacists’ contribution to the control of antibiotic resistance’. Brussels: Pharmaceutical Group of the European Union. 2009.
  108. Fang Y, Yang S, Zhou S, Jiang M, Liu J. Community pharmacy practice in China: past, present and future. Int J Clin Pharm. 2013 Aug;35(4):520-8. doi: 10.1007/s11096-013-9789-5. Epub 2013 May 10. PMID: 23661172.
  109. Mohanta GP, Manna PK, Valliappan K, Manavalan R. Achieving good pharmacy practice in community pharmacies in India. Am J Health Syst Pharm. 2001 May 1;58(9):809-10. doi: 10.1093/ajhp/58.9.809. PMID: 11351923.
  110. Rodis JL, Green CG, Cook SC, Pedersen CA. Effects of a pharmacist-initiated educational intervention on patient knowledge about the appropriate use of antibiotics. Am J Health Syst Pharm. 2004 Jul 1;61(13):1385-9. doi: 10.1093/ajhp/61.13.1385. PMID: 15287235.
  111. Kamba PF, Mulangwa J, Kaggwa B, Kitutu FE, Sewankambo NK, Katabira ET, Byakika-Kibwika P, Adome RO, Bollinger RC. Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study. Subst Abuse Treat Prev Policy. 2020 Feb 18;15(1):16. doi: 10.1186/s13011-020-00261-x. PMID: 32070374; PMCID: PMC7027211.
  112. Bahnassi A. A qualitative analysis of pharmacists’ attitudes and practices regarding the sale of antibiotics without prescription in Syria. J Taibah Univ Med Sci. 2015;10:227-233. doi: 10.1016/j.jtumed.2014.09.001
  113. Zawahir S, Lekamwasam S, Aslani P. Antibiotic dispensing practice in community pharmacies: A simulated client study. Res Social Adm Pharm. 2019 May;15(5):584-590. doi: 10.1016/j.sapharm.2018.07.019. Epub 2018 Jul 29. PMID: 30093309.
  114. Al-Hamad A. Over-the-counter delivery of antibiotics: are we sending the right message? Am J Infect Control. 2012 Feb;40(1):81-2. doi: 10.1016/j.ajic.2011.08.011. Epub 2011 Dec 2. PMID: 22137194.
  115. Bahta M, Tesfamariam S, Weldemariam DG, Yemane H, Tesfamariam EH, Alem T, Russom M. Dispensing of antibiotics without prescription and associated factors in drug retail outlets of Eritrea: A simulated client method. PLoS One. 2020 Jan 24;15(1):e0228013. doi: 10.1371/journal.pone.0228013. PMID: 31978180; PMCID: PMC6980490.
  116. Ansari M. Evaluation of community pharmacies regarding dispensing practices of antibiotics in two districts of central Nepal. PLoS One. 2017 Sep 26;12(9):e0183907. doi: 10.1371/journal.pone.0183907. PMID: 28949990; PMCID: PMC5614431.
  117. Akinyandenu O, Akinyandenu A. Irrational use and non-prescription sale of antibiotics in Nigeria: a need for change. J Sci Innovat Res. 2014;3(2):251-257.
  118. https://bit.ly/3bmGQQ4
  119. Hadi MA, Karami NA, Al-Muwalid AS, Al-Otabi A, Al-Subahi E, Bamomen A, Mohamed MM, Elrggal ME. Community pharmacists' knowledge, attitude, and practices towards dispensing antibiotics without prescription (DAwP): a cross-sectional survey in Makkah Province, Saudi Arabia. Int J Infect Dis. 2016 Jun;47:95-100. doi: 10.1016/j.ijid.2016.06.003. Epub 2016 Jun 22. PMID: 27343987.
  120. Chang J, Ye D, Lv B, Jiang M, Zhu S, Yan K, Tian Y, Fang Y. Sale of antibiotics without a prescription at community pharmacies in urban China: a multicentre cross-sectional survey. J Antimicrob Chemother. 2017 Apr 1;72(4):1235-1242. doi: 10.1093/jac/dkw519. PMID: 28062684.
  121. Broom A, Broom J, Kirby E, Plage S, Adams J. What role do pharmacists play in mediating antibiotic use in hospitals? A qualitative study. BMJ Open. 2015 Nov 3;5(11):e008326. doi: 10.1136/bmjopen-2015-008326. PMID: 26534731; PMCID: PMC4636622.
  122. Auta A, Hadi MA, Oga E, Adewuyi EO, Abdu-Aguye SN, Adeloye D, Strickland-Hodge B, Morgan DJ. Global access to antibiotics without prescription in community pharmacies: A systematic review and meta-analysis. J Infect. 2019 Jan;78(1):8-18. doi: 10.1016/j.jinf.2018.07.001. Epub 2018 Jul 5. PMID: 29981773.
  123. Sakeena MHF, Bennett AA, McLachlan AJ. Non-prescription sales of antimicrobial agents at community pharmacies in developing countries: a systematic review. Int J Antimicrob Agents. 2018 Dec;52(6):771-782. doi: 10.1016/j.ijantimicag.2018.09.022. Epub 2018 Oct 9. PMID: 30312654.
  124. Chang J, Xu S, Zhu S, Li Z, Yu J, Zhang Y, Zu J, Fang Y, Ross-Degnan D. Assessment of non-prescription antibiotic dispensing at community pharmacies in China with simulated clients: a mixed cross-sectional and longitudinal study. Lancet Infect Dis. 2019 Dec;19(12):1345-1354. doi: 10.1016/S1473-3099(19)30324-X. Epub 2019 Oct 3. Erratum in: Lancet Infect Dis. 2019 Oct 15;: PMID: 31588042.
  125. Kalungia AC, Burger J, Godman B, Costa JO, Simuwelu C. Non-prescription sale and dispensing of antibiotics in community pharmacies in Zambia. Expert Rev Anti Infect Ther. 2016 Dec;14(12):1215-1223. doi: 10.1080/14787210.2016.1227702. Epub 2016 Sep 9. PMID: 27548801.
  126. Kotwani A, Wattal C, Joshi PC, Holloway K. Irrational use of antibiotics and role of the pharmacist: an insight from a qualitative study in New Delhi, India. J Clin Pharm Ther. 2012 Jun;37(3):308-12. doi: 10.1111/j.1365-2710.2011.01293.x. Epub 2011 Aug 23. PMID: 21883328.
  127. Roque F, Herdeiro MT, Soares S, Teixeira Rodrigues A, Breitenfeld L, Figueiras A. Educational interventions to improve prescription and dispensing of antibiotics: a systematic review. BMC Public Health. 2014 Dec 15;14:1276. doi: 10.1186/1471-2458-14-1276. PMID: 25511932; PMCID: PMC4302109.
  128. Kalonga J, Hangoma J, Banda M, Munkombwe D, Mudenda S. Antibiotic Prescribing Patterns in Paediatric Patients at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia. Int J Pharm Pharmacol. 2020;4(1):138.
  129. https://bit.ly/3EuJzUe
  130. Zulu A, Matafwali SK, Banda M, Mudenda S. Assessment of knowledge, attitude, and practices on antibiotic resistance among undergraduate medical students in the school of medicine at the University of Zambia. Int J Basic Clin Pharmacol. 2020;9:263-270. doi: 10.18203/2319-2003.ijbcp20200174
  131. Ministry of Health. Multisectoral National Action Plan on Antimicrobial Resistance, Zambia. 2017-2027.
  132. https://bit.ly/31ebLw7
  133. Firouzabadi D, Mahmoudi L. Knowledge, attitude, and practice of health care workers towards antibiotic resistance and antimicrobial stewardship programmes: A cross-sectional study. J Eval Clin Pract. 2020 Feb;26(1):190-196. doi: 10.1111/jep.13177. Epub 2019 May 21. PMID: 31115129.
  134. Kalungia AC, Mwambula H, Munkombwe D, Marshall S, Schellack N, May C, Jones ASC, Godman B. Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice. J Chemother. 2019 Nov-Dec;31(7-8):378-387. doi: 10.1080/1120009X.2019.1622293. Epub 2019 May 30. PMID: 31145043.
Publish with JBRES — Peer-reviewed, multidisciplinary Open Access with rapid review, DOI, and global visibility.
Double-Blind CrossRef DOI Discoverable
Submit Manuscript Membership