Pharmacies and use of antibiotics: a cross sectional study in 19 Arab countries

Hadeer Hafez, Mohamed Saad Rakab, Adham Elshehaby, Ahmed Ibrahim Gebreel, Mohamed Hany, Mohammad BaniAmer, Mona Sajed, Sara Yunis, Sondos Mahmoud, Marwan Hamed, Maha Abdellatif, Aseel Nabeel Alomari, Amr Esam Moqbel, Omnia Samy El-Sayed, Mohamed Elshenawy, Mohamed Tolba, Muhammad Saeed
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Abstract

The rise of antimicrobial resistance, which is partially attributed to the overuse and/or misuse of antibiotics in health care, is one of the world’s largest public health challenges. The distribution of antibiotics in absence of a prescription in pharmacies is a significant contributor to the growing global public health crisis of antibiotic resistance. A pharmacist’s clinical and lawful knowledge of antibiotic provide has an impact on the proper way to dispense medication. There are few novel studies assessing pharmacists comprehension and experience in prescribing antibiotics in low- and middle-income countries, including those in the Arabian region. (I) assess pharmacy team members Knowledge about antibiotics as reported by individuals themselves and their behavior in dispensing antimicrobial without a prescription and (ii) find potential influences on this behavior. Pharmacists were chosen from various regions in Algeria, Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen, based on their convenience and ease of access. A descriptive cross-sectional assessment among a random sample (n = 2833) of community pharmacists was conducted Utilizing a structured, validated, and questionnaire that underwent pilot testing, a comprehensive survey with four distinct sections covering biography, knowledge, practice, and attitude domains was employed. Measures were knowledge, attitude, and practice toward dispensing antibiotics without prescription. Of the 3100 pharmacists reached, 2833 completed and return the questionnaires (response rate 91.3%). Most of the respondents were male (57.4%). Aged between 19 and 31 years old (76.2%). Most of them held a B.Sc. Degree (78.5%). Worked as staff pharmacists (73.2%). During the survey, it was discovered that there were gaps in their knowledge regarding antibiotic usage. A total of 45.7% of the respondents were unaware that antibiotics can be used as prophylaxis, while 33.3% did not recognize the consequences of making incorrect antibiotic choices. Regarding their practice patterns, 53.8% of the pharmacists admitted that they did not consistently adhere to guidelines when dispensing antibiotics. In terms of attitudes toward antibiotic usage, 36.8% disagreed with the guidelines of not supply antibiotics without a prescription, suggesting some variation in opinions among pharmacists on this matter. Additionally, a significant percentage (75%) believed that community pharmacists had qualifications to prescribe antibiotics for infections. The recent survey has shed light on the differences among pharmacists in regard to dispensing antibiotics without prescriptions and their understanding of resistance. The findings are concerning, indicating a deficient in of knowledge as regards the use of antibiotics. It is crucial to implement regulations and enhance education efforts to tackle the growing problem of resistance. Collaboration between healthcare professionals and awareness campaigns is essential in addressing this issue. Community pharmacists may contribute to inappropriate antibiotic usage and microbial resistance by distributing antibiotics without a prescription. It is crucial to develop and put into action a clear strategy to promote sensible antibiotic usage in a community pharmacy context. It is advised that instructional tactics regarding the prescription of antibiotics and antibiotic resistance be improved. To changing community pharmacists’ dispensing practices, educational programs emphasizing attitude adjustments and acknowledging the professional code of ethics are required. Community pharmacists can modify patient behaviors and educate patients on the proper use of antibiotics.
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药店与抗生素的使用:19 个阿拉伯国家的横断面研究
抗菌药耐药性的增加是世界上最大的公共卫生挑战之一,其部分原因是在医疗保健中过度使用和/或滥用抗生素。药房在没有处方的情况下分发抗生素,是导致抗生素耐药性这一日益严重的全球公共卫生危机的重要原因。药剂师的抗生素临床和法律知识对正确的配药方式有影响。在中低收入国家(包括阿拉伯地区),很少有新的研究对药剂师开具抗生素处方的理解和经验进行评估。本研究的目的是:(I) 评估药剂师团队成员自己报告的抗生素知识,以及他们在没有处方的情况下配发抗菌药物的行为;(ii) 找出这种行为的潜在影响因素。药剂师来自阿尔及利亚、巴林、埃及、伊拉克、约旦、科威特、黎巴嫩、利比亚、摩洛哥、阿曼、巴勒斯坦、卡塔尔、沙特阿拉伯、索马里、苏丹、叙利亚、突尼斯、阿拉伯联合酋长国和也门的不同地区,根据其便利性和易访问性进行选择。在随机抽样(n = 2833)的社区药剂师中进行了描述性横断面评估 采用了经过试点测试的结构化有效问卷,综合调查包括四个不同的部分,涵盖传记、知识、实践和态度领域。调查内容包括无处方配发抗生素的知识、态度和实践。在受访的 3100 名药剂师中,有 2833 人填写并交回了问卷(回复率为 91.3%)。大多数受访者为男性(57.4%)。年龄在 19 至 31 岁之间(76.2%)。大多数拥有理学士学位(78.5%)。担任药剂师(73.2%)。在调查中发现,他们对抗生素使用的认识存在差距。共有 45.7% 的受访者不知道抗生素可用作预防药物,33.3% 的受访者没有认识到错误选择抗生素的后果。在执业模式方面,53.8% 的药剂师承认,他们在配发抗生素时并没有始终如一地遵守指导原则。在对抗生素使用的态度方面,36.8% 的药剂师不同意在没有处方的情况下不提供抗生素的指导原则,这表明药剂师在这一问题上的观点存在一定差异。此外,相当大比例(75%)的人认为社区药剂师有资格开抗生素治疗感染。最近的调查揭示了药剂师在无处方配发抗生素方面的差异,以及他们对抗药性的理解。调查结果令人担忧,表明抗生素使用方面的知识不足。为解决日益严重的抗药性问题,实施相关法规并加强教育工作至关重要。医护人员之间的合作和宣传活动对于解决这一问题至关重要。社区药剂师可能会在没有处方的情况下分发抗生素,从而导致抗生素使用不当和微生物耐药性。制定并实施明确的策略,促进社区药房合理使用抗生素至关重要。建议改进有关抗生素处方和抗生素耐药性的指导策略。为了改变社区药剂师的配药行为,需要开展强调调整态度和承认职业道德准则的教育计划。社区药剂师可以改变患者的行为,教育患者正确使用抗生素。
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