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Knowledge, Attitude, and Practice on Antibiotics and Its Resistance: A Two-Phase Mixed-Methods Online Study among Pakistani Community Pharmacists to Promote Rational Antibiotic Use

Author

Listed:
  • Faiz Ullah Khan

    (Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Farman Ullah Khan

    (Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Khezar Hayat

    (Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Tawseef Ahmad

    (Department of Pharmacy, Abbottabad Campus, COMSATS University Islamabad, Abbottabad 22060, Pakistan)

  • Amjad Khan

    (Department of Pharmacy, Quaid-i-Azam University, Islamabad 45320, Pakistan)

  • Jie Chang

    (Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Usman Rashid Malik

    (Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Zakir Khan

    (Department of Pharmacy, Quaid-i-Azam University, Islamabad 45320, Pakistan
    Department of Pharmacology, Institute of Health Sciences, Çukurova Universitesy, Adana 01330, Turkey)

  • Krizzia Lambojon

    (Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Yu Fang

    (Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

Abstract

Antibiotic resistance (ABR) is an emerging global threat to public health. Substantial evidence has indicated that community pharmacists (CPs) can play a critical role in managing the ever-increasing threat of antibiotic resistance. This study aimed to determine the knowledge, attitude, and practices of CPs ( n = 180) towards antibiotics and antibiotic resistance as well as to improve the rational use of antibiotics. A two-phase mixed-methods (quantitative and qualitative) online study was conducted in Pakistan from August 2019 to March 2020 by using validated questionnaires and semi-structured interview data. Different statistical methods were used to tabulate the quantitative data, whereas inductive thematic analysis was conducted to categorize themes from the qualitative data and to draw conclusions. Approximately 64.4% of the CPs were male (mean: 29–33 years old). Overall, CPs had good knowledge of and were familiar with multidrug-resistant organisms and their roles in ABR (65.6%, median = 1, and IQR = 1), although their knowledge was poor in differentiating some antibiotic groups with their respective ABR patterns (31.1%, median = 1, and IQR = 1). Most CPs have a positive attitude towards antibiotics, with most (90.0%) identifying ABR as a critical issue in public health (median = 1 and IQR = 0). Overall, CPs’ practices towards antibiotics were somewhat acceptable, where they leaned towards educating patients about the rational use of antibiotics (52.8%, median = 1, and IQR = 1). The two main themes discovered (antibiotics and counseling of patients) were related to self-medication, while educational intervention is the main subtheme. ABR is multifactorial, with subthemes related to budget, time constraints, incompetent staff, the absence of CPs, the lack of training, and the enforcement of laws and regulations being the needs of the hour in Pakistan. Effective antibiotic stewardship programs, patient education, and awareness campaigns about antibiotics and ABR along with training of the CPs are important factors that have to be addressed in a timely manner.

Suggested Citation

  • Faiz Ullah Khan & Farman Ullah Khan & Khezar Hayat & Tawseef Ahmad & Amjad Khan & Jie Chang & Usman Rashid Malik & Zakir Khan & Krizzia Lambojon & Yu Fang, 2021. "Knowledge, Attitude, and Practice on Antibiotics and Its Resistance: A Two-Phase Mixed-Methods Online Study among Pakistani Community Pharmacists to Promote Rational Antibiotic Use," IJERPH, MDPI, vol. 18(3), pages 1-16, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:3:p:1320-:d:491309
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    References listed on IDEAS

    as
    1. Muhammad Majid Aziz & Minghuan Jiang & Imran Masood & Jie Chang & Shan Zhu & Muhammad Ali Raza & Wenjing Ji & Caijun Yang & Yu Fang, 2019. "Patients’ Anticipation for the Pharmacies of Rural Communities: A Qualitative Study from Pakistan," IJERPH, MDPI, vol. 16(1), pages 1-14, January.
    2. Shukry Zawahir & Sarath Lekamwasam & Parisa Aslani, 2019. "A cross-sectional national survey of community pharmacy staff: Knowledge and antibiotic provision," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-15, April.
    3. Benjamin Saunders & Julius Sim & Tom Kingstone & Shula Baker & Jackie Waterfield & Bernadette Bartlam & Heather Burroughs & Clare Jinks, 2018. "Saturation in qualitative research: exploring its conceptualization and operationalization," Quality & Quantity: International Journal of Methodology, Springer, vol. 52(4), pages 1893-1907, July.
    4. Muhammad Majid Aziz & Wenjing Ji & Imran Masood & Muhammad Farooq & Muhammad Zubair Malik & Jie Chang & Minghuan Jiang & Naveel Atif & Yu Fang, 2018. "Patient Satisfaction with Community Pharmacies Services: A Cross-Sectional Survey from Punjab; Pakistan," IJERPH, MDPI, vol. 15(12), pages 1-14, December.
    5. Khezar Hayat & Meagen Rosenthal & Ali Hassan Gillani & Panpan Zhai & Muhammad Majid Aziz & Wenjing Ji & Jie Chang & Hao Hu & Yu Fang, 2019. "Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study," IJERPH, MDPI, vol. 16(9), pages 1-15, May.
    6. Khezar Hayat & Meagen Rosenthal & Sen Xu & Muhammad Arshed & Pengchao Li & Panpan Zhai & Gebrehaweria Kassa Desalegn & Yu Fang, 2020. "View of Pakistani Residents toward Coronavirus Disease (COVID-19) during a Rapid Outbreak: A Rapid Online Survey," IJERPH, MDPI, vol. 17(10), pages 1-10, May.
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