Abstract
Objective: Community pharmacists have an important role in promoting the appropriate use of antibiotics. There is a paucity of data describing the contributions of community pharmacists in antimicrobial stewardship program (ASP) in Nigeria. This study evaluated the practices and perceptions of community pharmacists towards ASP.
 Methods: This was a cross-sectional study conducted among community pharmacists in two cities in Northern Nigeria: Minna and Kaduna, using a 30-item validated and pre-tested questionnaire. Data collected between April and May 2019 and analyzed using SPSS version 23.
 Results: Of 130 community pharmacists, 98 completed and returned the questionnaire (response rate: 75.3%). More than 90% strongly agreed/agreed that ASP is important to reduce inappropriate use of antibiotics and antibiotic resistance, improve patient’s clinical outcomes. However, lack of training (56.1%), lack of cooperation from physicians (61.2%) and lack of access to patient records (66.8%) were identified as barriers to community pharmacists’ involvement in ASP. Overall, community pharmacists had good practices (median score: 3.5; IQR: 1–5) and positive perceptions (median score: 4.0; IQR: 3–5) towards ASP. Job status and dispensing antibiotics without prescription were significantly associated with practice, while age and job status were associated with perception towards ASP.
 Conclusion: Community pharmacists demonstrated good practices and positive perceptions towards ASP. However, lack of training and lack of cooperation from prescribers limit their involvement in the program. Training of community pharmacists in antimicrobial stewardship and inter-professional collaboration are recommended.
Highlights
The escalation of antibiotic resistance, coupled with the lack of new agents in the development pipeline, have caused an antibiotic crisis that threatens global health security [1]
The current study found that community pharmacists had positive perceptions and good Antimicrobial stewardship (AMS) practices
The current study revealed that most community pharmacists had positive perceptions towards the goals of AMS and the motivations to participate in the program
Summary
The escalation of antibiotic resistance, coupled with the lack of new agents in the development pipeline, have caused an antibiotic crisis that threatens global health security [1]. Inappropriate use of antibiotics; in both community and hospital settings contributes to the emergence and spread of antibiotic resistance [1]. Illicit sale of antibiotics and self-medication are serious issues that affect antibiotic resistance. Population studies have shown that non-prescription use of antibiotics is higher in Africa compared to Europe, Asia and the Middle East [4]. The prevalence of non-prescription dispensing of antibiotics in community pharmacy is 62% [5]. Dispensing antibiotics without prescription poses a greater threat to antibiotic resistance compared to prescription use due to high rate of selection and dosing errors associated with the former [4]. Non-prescription antibiotics are often used for the treatment of self-limiting illnesses, including upper respiratory tract infections [5]
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