Knowledge, practice and attitudes of pharmacists towards dispensing antibiotics in Sri Lanka

Abstract

Antibiotic resistance is one of the biggest threats to global health today. Although antibiotic resistance occurs naturally, misuse is accelerating the process. Community pharmacists, owing to their role in dispensing antibiotics must be knowledgeable about the issue and actively involved in the solution. This study was designed to determine the knowledge, practices and attitudes (KPAs) of pharmacists towards dispensing antibiotics. A cross-sectional survey was conducted in eight districts (Anuradhapura, Gampaha, Kandy, Kurunegala, Kegalle, Matara, Matale and Puttalam) covering 80 drug outlets/pharmacies. A pretested semi-structured questionnaire gathered information from the pharmacists through interviews after obtaining verbal consent. There were 37 males and 43 females, among which only 36% were qualified pharmacists while the others who were involved in dispensing drugs were the owner of the outlet (17%), manager (5%), and sales associate (38%). Few (4%) claimed that they did not have proper status. Dispensing antibiotics without proper prescription was reported in all the outlets visited in the Anuradapura and Kurunagala districts while about half of those in the rest of the districts. However, in Matara district, only 10% of the respondents claimed that customers request antibiotics without a prescription. The majority of the respondents (60%) had scored 50% or more for the questions assessing KPAs. Level of education and years of experience did not have a relationship with the KPA score. However, the employment status of the respondent significantly contributed to the KPA scores (Fisher's Exact test, p=0.0025), designated pharmacists scoring higher. The observation checklist had noted that at some outlets, the guidelines for storage of drugs were not practiced. Survey results show that employing proper pharmacists in dispensing drugs is important in preventing misuse of antibiotics and maximizing the utility of available drugs. The importance of conducting pharmacist-directed antibiotic stewardship programs is therefore highlighted.