Pharmacists’ knowledge, attitudes, and practices of dispensing antibiotics without a prescription

Abstract

Background: Antibiotics have become some of the most widely used and essential tools in the healthcare system, with the advantage of saving millions of lives. However, the overuse and misuse of antibiotics led to the emergence of resistant microorganisms. Objective: To assess community pharmacists’ knowledge, attitude, and practice in relation to dispensing antibiotics without prescription. Methods: In this cross sectional study, a validated survey was distributed in person as Google Forms to community pharmacists across different regions in Jordan using convenience sampling. A quantile regression was conducted to explore the factors associated with attitude and practice of antibiotics dispensing without prescription. Results: Pharmacists (N=351) exhibited moderate knowledge regarding antibiotic use and resistance, with a median score of 4 (range 3-5) out of a possible 7 points. The median attitude score was 22 (20-24), out of maximum possible score of 25, indicating favourable attitudes towards antibiotics prescription. Regression analysis demonstrated that higher knowledge scores were associated with higher attitude scores (coefficient = 0.106, 95%CI: 0.007 - 0.206, p = 0.036). Additionally, higher attitude scores were linked to a reduced likelihood of dispensing antibiotics without a prescription (coefficient = -0.302, 95%CI: 0.588 - 0.929, p = 0.010). Conclusion: The study indicated moderate knowledge of antibiotics among pharmacists and a generally favourable attitude toward their prescription. Greater knowledge was associated with a more positive attitude, which was linked to a lower likelihood of dispensing antibiotics without a prescription. Future initiatives should aim to enhance pharmacists' understanding of antibiotic use and resistance, as well as implement stricter dispensing regulations to reduce the use of antibiotics without prescriptions and address antimicrobial resistance.