Community Pharmacists' Knowledge, Perceptions and Practices Regarding Antibiotic Use and Antimicrobial Resistance in Lusaka, Zambia.

BACKGROUND

The inappropriate use of antibiotics is a major contributor to antibacterial resistance, which poses a serious threat to global health. Community pharmacists (CPs) play an essential role in promoting antimicrobial stewardship and the prudent use of antibiotics.

AIMS: This study evaluated CPs' antibiotic dispensing practices, knowledge and perceptions of antibiotics and antibiotic resistance.

METHODS

This cross-sectional survey was conducted among 254 CPs in Lusaka using an adapted self-administered questionnaire. Data were analysed using STATA Version 15.1. Bivariate and multivariable logistic regression analyses identified factors associated with good knowledge and practices regarding antibiotics and antibiotic resistance.

RESULTS

Of the 254 CPs, 206 (81.0%) demonstrated adequate knowledge, 217 (85.4%) had positive perceptions, and 155 (61.0%) exhibited good antibiotic dispensing practices. However, most pharmacists, 169/254 (66.6%), reported that they only sometimes or rarely dispensed antibiotics strictly upon presentation of a prescription, while 233 (91.7%) perceived weak regulations and inadequate monitoring as facilitating nonprescription antibiotic dispensing. In the adjusted analysis, male pharmacists had lower odds of adequate knowledge (adjusted odds ratio [AOR] = 0.3, 95% confidence interval [CI]: 0.14-0.64) but higher odds of good dispensing practices (AOR = 2.3, 95% CI: 1.27-4.11) than females. Part-time pharmacists also had higher odds of adequate knowledge than full-time pharmacists (AOR = 1.5, 95% CI: 1.06-2.21).

CONCLUSIONS

CPs demonstrated high levels of knowledge, positive perceptions and generally good antibiotic dispensing practices. Nevertheless, frequent dispensing without prescriptions remained common, indicating important gaps in adherence to recommended dispensing standards. Strengthening regulatory oversight, routine monitoring and targeted antimicrobial stewardship interventions is necessary to promote consistent and responsible antibiotic dispensing in community pharmacies.