Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan

Background There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.Objective To explore the determinants of AMR and the pattern of antimicrobial dispensing among community phar...

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Main Authors: Mohamed Azmi Hassali, Zikria Saleem, Furqan Khurshid Hashmi, Brian Godman, Fahad Saleem
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:Family Medicine and Community Health
Online Access:https://fmch.bmj.com/content/7/3/e000138.full
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author Mohamed Azmi Hassali
Zikria Saleem
Furqan Khurshid Hashmi
Brian Godman
Fahad Saleem
author_facet Mohamed Azmi Hassali
Zikria Saleem
Furqan Khurshid Hashmi
Brian Godman
Fahad Saleem
author_sort Mohamed Azmi Hassali
collection DOAJ
description Background There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.Objective To explore the determinants of AMR and the pattern of antimicrobial dispensing among community pharmacists.Design In this qualitative study design, a semistructured interview guide was developed based on an in-depth review of published papers. Audio-recorded interviews with transcripts were analysed by thematic content analysis.Setting Interviews were conducted among community pharmacists in Lahore, Pakistan.Participants In order to obtain individual points of view, in-depth face-to-face interviews with purposively selected pharmacists were conducted.Results A total of 12 pharmacists were interviewed for the study. After analysis, four major themes emerged: (1) knowledge and perception of community pharmacists about antimicrobials, (2) antimicrobial dispensing practices of community pharmacists, (3) determinants of AMR, (4) potential interventions to control AMR. Most of the pharmacists have limited knowledge about AMR, antimicrobial stewardship programmes and related guidelines. However, all the pharmacists strongly agreed that different appropriate actions should be taken in order to rationalise future antimicrobial use.Conclusion The results indicated that irrational antimicrobial dispensing and use is common among community pharmacists in Pakistan owing to lack of knowledge. The community pharmacists perceived that behaviour of patients and the societal environment contributed to irrational antimicrobial use and subsequent development of AMR. They suggested a need for a multidisciplinary framework in order to improve future antimicrobial use and reduce AMR in Pakistan.
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spelling doaj-art-82e202b264f04321a955adeb6435c1272025-08-20T02:12:10ZengBMJ Publishing GroupFamily Medicine and Community Health2305-69832009-87742019-07-017310.1136/fmch-2019-000138Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in PakistanMohamed Azmi Hassali0Zikria Saleem1Furqan Khurshid Hashmi2Brian Godman3Fahad Saleem4School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MalaysiaSchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MalaysiaUniversity College of Pharmacy, University of the Punjab, Lahore, PakistanStrathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UKFaculty of Pharmacy and Health sciences, University of Balochistan, Quetta, PakistanBackground There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.Objective To explore the determinants of AMR and the pattern of antimicrobial dispensing among community pharmacists.Design In this qualitative study design, a semistructured interview guide was developed based on an in-depth review of published papers. Audio-recorded interviews with transcripts were analysed by thematic content analysis.Setting Interviews were conducted among community pharmacists in Lahore, Pakistan.Participants In order to obtain individual points of view, in-depth face-to-face interviews with purposively selected pharmacists were conducted.Results A total of 12 pharmacists were interviewed for the study. After analysis, four major themes emerged: (1) knowledge and perception of community pharmacists about antimicrobials, (2) antimicrobial dispensing practices of community pharmacists, (3) determinants of AMR, (4) potential interventions to control AMR. Most of the pharmacists have limited knowledge about AMR, antimicrobial stewardship programmes and related guidelines. However, all the pharmacists strongly agreed that different appropriate actions should be taken in order to rationalise future antimicrobial use.Conclusion The results indicated that irrational antimicrobial dispensing and use is common among community pharmacists in Pakistan owing to lack of knowledge. The community pharmacists perceived that behaviour of patients and the societal environment contributed to irrational antimicrobial use and subsequent development of AMR. They suggested a need for a multidisciplinary framework in order to improve future antimicrobial use and reduce AMR in Pakistan.https://fmch.bmj.com/content/7/3/e000138.full
spellingShingle Mohamed Azmi Hassali
Zikria Saleem
Furqan Khurshid Hashmi
Brian Godman
Fahad Saleem
Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
Family Medicine and Community Health
title Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
title_full Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
title_fullStr Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
title_full_unstemmed Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
title_short Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
title_sort antimicrobial dispensing practices and determinants of antimicrobial resistance a qualitative study among community pharmacists in pakistan
url https://fmch.bmj.com/content/7/3/e000138.full
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