Knowledge, Attitude, and Practices of Community Pharmacists on Antibiotic Resistance and Antimicrobial Stewardship in Lusaka, Zambia

Abstract
Background: Antimicrobial/Antibiotic Resistance (AMR) is among the major threats to global health. Due to limited information on the subject matter in Zambia, we assessed the knowledge, attitude, and practices of community pharmacists on AMR and Antimicrobial Stewardship (AMS). Materials and Methods: We conducted a descriptive cross-sectional study among 144 randomly selected community pharmacists through a structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22 at a 95% confidence level. The Fisher’s exact test was used to determine the relationship between sociodemographic factors of community pharmacists and their knowledge, attitude, and practices on antibiotic resistance and antimicrobial stewardship. Results: A response rate of 91% (n = 144) was achieved. Interestingly, 93.8% had good knowledge while 67% had positive attitudes regarding AMR and AMS. Conversely, 75% of the community pharmacists demonstrated poor practices towards AMR and AMS. The majority of the CPs 69.4% agreed that antibiotic resistance is a public health problem. The majority of the CPs 57.6% agreed that the appropriate use of antibiotics improves patient care and outcome. Of concern, (32.6%) of CPs rarely collaborated with other healthcare workers in activities that promote infection control and AMS. Also, the majority of the CPs did not take part in antibiotic awareness campaigns nor educate the public on antibiotic use and over 80% of CPs regularly issued antibiotics without a prescription. Conclusions: Even though community pharmacists had good knowledge and positive attitudes, they demonstrated poor practices that require quick educational interventions. As most CPs issue antibiotics without a prescription, this should be highlighted as a major policy issue on AMR and should be addressed by the Government. There is a need to promote AMS sensitization programmes among community pharmacists.