Abstract
Inappropriate use of antibiotics has been reported to contribute to the emergence and increase of antimicrobial resistance (AMR) in the world. The pharmacist has the responsibility to supervise the dispensing of antibiotics with prescriptions to ensure rational use. An online semi-structured questionnaire was shared with approximately 1100 licensed pharmacists in Tanzania. Study data were collected and managed using REDCap electronic data capture tools before use for analysis. Of the 226 (20.5%) received responses, 197 had given consent and provided complete surveys. Notably, 153 (77.7%) of the 197 pharmacists had excellent knowledge about the legal requirements for dispensing antibiotics and the AMR challenge. Of the 197 surveyed pharmacists, 143 (72.6%) admitted to dispensing antibiotics without a prescription in their daily practice. Notably, 84.1% (37/44) of pharmacists with masters or PhD education were more likely to dispense without a prescription compared to 69.3% (106/153) among bachelor holders (p-value = 0.04). The reasons for administering antibiotics without a prescription included the pharmacy business looking for more profit, patient failure to obtain a prescription and the lack of stringent inspection of pharmacies by the regulatory authorities. Penicillins, macrolides and fluoroquinolones were the classes of antibiotics most commonly dispensed without a prescription. Stringent inspections by the regulatory authorities should detect and reduce dispensing antibiotics without a prescription. The community should be educated on the importance of medication prescription from a qualified medical practitioner.
Highlights
Antimicrobial resistance (AMR) is a growing problem in healthcare systems and occurs when previously susceptible microorganisms develop resistance to the previously effective antimicrobials [1].Both appropriate and inappropriate use of antimicrobial agents has led to the development of AMR.Besides, some bacteria may have intrinsic structural and functional characteristics that make them naturally resistant to antibiotics [2]
We evaluated pharmacists based reasons for dispensing antibiotics without a prescription, including the profit-oriented nature of pharmacy business, the relationship between the pharmacist and the patient and the belief that pharmacists are knowledgeable enough to dispense without a prescription
The Tanzanian pharmacists seem to be knowledgeable of the legal requirements to dispense antibiotics, the antimicrobial resistance threat and its consequences to both patient and the public
Summary
Antimicrobial resistance (AMR) is a growing problem in healthcare systems and occurs when previously susceptible microorganisms develop resistance to the previously effective antimicrobials [1].Both appropriate and inappropriate use of antimicrobial agents has led to the development of AMR.Besides, some bacteria may have intrinsic structural and functional characteristics that make them naturally resistant to antibiotics [2]. Antimicrobial resistance (AMR) is a growing problem in healthcare systems and occurs when previously susceptible microorganisms develop resistance to the previously effective antimicrobials [1]. Both appropriate and inappropriate use of antimicrobial agents has led to the development of AMR. Inappropriate use of antimicrobials such as underuse, overuse or misuse are the leading causes for the development of AMR yet are preventable [3]. AMR has many consequences to both individual patients and the public at large, such as increasing cost, the burden of treatment, poor treatment outcome, and spread of the resistant microbes to other people endangering the public health [4,5].
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