AWARENESS AMONGST SERVICE PROVIDERS AND PATIENTS REGARDING THE USE AND DISPENSE OF ANTIBIOTICS A CROSS-CITY ANALYSIS IN PAKISTAN
Main Article Content
Keywords
Antibiotics, resistance, attitude, knowledge and practices
Abstract
The main objective of this study is to create awareness among service providers and patients regarding the use and dispensing of antibiotics in different cities in Pakistan. This study was qualitative, and semi-structured interviews were conducted to collect data regarding antibiotics. The study has been conducted in big cities in Pakistan. The population for this study consisted of all pharmacies and government and private hospitals. The study's sample size is 14 participants, 07 healthcare providers, and 07 patients. The study used thematic content analysis, a technique that finds and analyses themes or patterns in a data set. Four (4) themes and sixteen (16) sub-themes were identified based on past literature. The main themes include Participants attitude (self-medication & attitude toward antibiotic use), Participant's knowledge (antibiotics knowledge, Antimicrobial Stewardship awareness, knowledge of antibiotics resistance & risk awareness), participant's practices (appropriate antibiotics consumption, healthcare professional consultation, pharmacy practices, dispensing antibiotics without prescription & guidance to patients) and Suggestions for rational dispense and use of antibiotics (prescriber must not prescribe unnecessary antibiotics, Antibiotics have separate regulations, have moral fear for non-prescription antibiotics and put the responsibility, need community-based awareness programs, healthcare providers must look twice at the antibiotic’s prescription & the pharmacist must educate people). Data and responses of participants were visualized with the help of a cloud diagram. A codebook was created to understand the complete picture of themes and sub-themes of this study. The majority of participants lacked sufficient understanding of antibiotics and their resistance. At the end, recommendations were given for the rational dispense and use of antibiotics.
References
1. Abbas, M., Inam, A., Tahira, E., Qamar, H., Shakil, J., & Bashir, S. (2021). Prescribing practices at a secondary healthcare setting of Islamabad, Pakistan: a descriptive cross-sectional study. Journal of Pharmaceutical Health Services Research, 12(2), 152-158.
2. Ahmed, H., Bhimani, S., Khanum, I., Khan, A., Khetpal, A., Abbas, M. A., … Makhdoom, I. U.-H. M. (2020). Knowledge, attitude and perception survey of doctors regarding antibiotic use and resistance in Karachi, Pakistan. JPMA. The Journal of the Pakistan Medical Association, 70(6), 1023–1028. doi:10.5455/JPMA.6239
3. Ahmad, T., Khan, F. U., Ali, S., Rahman, A. U., & Ali Khan, S. (2022). Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client’s study. PLoS One, 17(2), e0263756.
4. Afzal, S., Khan, F. U., Aqeel, M. T., Ullah, M., Bajwa, M., Akhtar, M., & Majid, M. (2024). Impact of a pharmacist-led educational intervention on knowledge, attitude, and practice toward the rational use of antibiotics among healthcare workers in a secondary care hospital in Punjab, Pakistan. Frontiers in Pharmacology, 14, 1327576.
5. Akhund, R., Jamshed, F., Jaffry, H. A., Hanif, H., & Fareed, S. (2019). Knowledge and attitude of general Pakistani population towards antibiotic resistance. Cureus, 11(3).
6. Alkadhimi, A., Dawood, O. T., & Hassali, M. A. (2020). Dispensing of antibiotics in community pharmacy in Iraq: a qualitative study. Pharmacy Practice, 18(4), 2095. doi:10.18549/PharmPract.2020.4.2095
7. Atif, M., Asghar, S., Mushtaq, I., & Malik, I. (2020). Community pharmacists as antibiotic stewards: A qualitative study exploring the current status of Antibiotic Stewardship Program in Bahawalpur, Pakistan. Journal of infection and public health, 13(1), 118–124. https://doi.org/10.1016/j.jiph.2019.07.003
8. Antimicrobial resistance. (2023.). Retrieved 15 June 2024, from https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
9. Aziz, M. M., Haider, F., Rasool, M. F., Hashmi, F. K., Bahsir, S., Li, P., ... & Fang, Y. (2021). Dispensing of non-prescribed antibiotics from community pharmacies of Pakistan: A cross-sectional survey of pharmacy staff’s opinion. Antibiotics, 10(5), 482.
10. Aziz, M. M., & Fang, Y. (2019). Pakistan should immediately curb the sale of non‐prescribed antibiotics from community pharmacies. The International Journal of Health Planning and Management, 34(2), e1376-e1377.
11. Auta, A., Hadi, M. A., Oga, E., Adewuyi, E. O., Abdu-Aguye, S. N., Adeloye, D., ... & Morgan, D. J. (2019). Global access to antibiotics without prescription in community pharmacies: a systematic review and meta-analysis. Journal of Infection, 78(1), 8-18.
12. Belachew, S. A., Hall, L., & Selvey, L. A. (2022). Community drug retail outlet staff’s knowledge, attitudes and practices towards non-prescription antibiotics use and antibiotic resistance in the Amhara region, Ethiopia with a focus on non-urban towns. Antimicrobial Resistance and Infection Control, 11(1), 64. doi:10.1186/s13756-022-01102-1
13. Bianco, A., Licata, F., Trovato, A., Napolitano, F., & Pavia, M. (2021). Antibiotic-dispensing practice in community pharmacies: Results of a cross-sectional study in Italy. Antimicrobial Agents and Chemotherapy, 65(6). doi:10.1128/AAC.02729-20
14. Browne, A. J., Chipeta, M. G., Haines-Woodhouse, G., Kumaran, E. P. A., Hamadani, B. H. K., Zaraa, S., … Dolecek, C. (2021). Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study. The Lancet. Planetary Health, 5(12), e893–e904. doi:10.1016/s2542-5196(21)00280-1
15. Cadogan, C. A., & Hughes, C. M. (2021). On the frontline against COVID-19: Community pharmacists’ contribution during a public health crisis. Research in Social and Administrative Pharmacy, 17(1), 2032-2035.
16. Chukwu, E. E., Oladele, D. A., Enwuru, C. A., Gogwan, P. L., Abuh, D., Audu, R. A., & Ogunsola, F. T. (2021). Antimicrobial resistance awareness and antibiotic prescribing behavior among healthcare workers in Nigeria: a national survey. BMC Infectious Diseases, 21(1), 22. https://doi:10.1186/s12879-020-05689-x
17. Dyar, O. J., Beovic, B., Vlahovic-Palčevski, V., Verheij, T., Pulcini, C., & on behalf of ESGAP (the ESCMID [European Society of Clinical Microbiology and Infectious Diseases] Study Group for Antibiotic Policies) (2016). How can we improve antibiotic prescribing in primary care?. Expert review of anti-infective therapy, 14(4), 403–413. https://doi.org/10.1586/14787210.2016.1151353
18. Elliott, V. (2018). Thinking about the coding process in qualitative data analysis. Qualitative report, 23(11).
19. Friese, S., Soratto, J., & Pires, D. (2018). Carrying out a computer-aided thematic content analysis with ATLAS. IWMI Working Papers, 18.
20. Gajdacs, M., Paulik, E., & Szabo, A. (2020). Knowledge, attitude and practice of community pharmacists regarding antibiotic use and infectious diseases: a cross-sectional survey in Hungary (KAPPhA-HU). Antibiotics, 9(2), 41.
21. Gould, K. (2016). Antibiotics: from prehistory to the present day. The Journal of Antimicrobial Chemotherapy, 71(3), 572–575. doi:10.1093/jac/dkv484
22. Gillani, A. H., Chang, J., Aslam, F., Saeed, A., Shukar, S., Khanum, F., … Fang, Y. (2020). Public knowledge, attitude, and practice regarding antibiotics use in Punjab, Pakistan: a cross-sectional study. Expert Review of Anti-Infective Therapy, 19(3), 399–411. https://doi.org/10.1080/14787210.2021.1823216
23. Hutchings, M. I., Truman, A. W., & Wilkinson, B. (2019). Antibiotics: past, present and future. Current Opinion in Microbiology, 51, 72–80. doi:10.1016/j.mib.2019.10.008
24. Imtiaz, F. , Hafeez, A., Ashraf, F.,& Imtiaz, H. (2017). Antibiotic Dispensing & Prescription Pattern in Pharmacies of Islamabad & Rawalpindi: Pakistan. International Journal of Collaborative Research on Internal Medicine & Public Health, 9(5), 683-692.
25. Khan, F. U., Khan, F. U., Hayat, K., Ahmad, T., Khan, A., Chang, J., … Fang, Y. (2021). Knowledge, attitude, and practice on antibiotics and its resistance: A two-phase mixed-methods online study among Pakistani community pharmacists to promote rational antibiotic use. International Journal of Environmental Research and Public Health, 18(3), 1320. doi:10.3390/ijerph18031320
26. Khan, F. U., Khan, F. U., Hayat, K., Chang, J., Saeed, A., Khan, Z., … Fang, Y. (2020). Knowledge, attitude and practices among consumers toward antibiotics use and antibiotic resistance in Swat, Khyber-Pakhtunkhwa, Pakistan. Expert Review of Anti-Infective Therapy, 18(9), 937–946. https://doi.org/10.1080/14787210.2020.1769477
27. Khan, F. U., and Fang, Y. (2021). Effectiveness of Pharmacist-Led Brief Educational Intervention for Adherence to the Antibiotics for Lower Respiratory Tract Infections (EATSA) in Post-Conflict Rural Areas of Pakistan: Study Protocol for a Randomized Controlled Trial. Antibiotics (Basel) 10, 1147. doi:10.3390/antibiotics10101147
28. Koji, E. M., Gebretekle, G. B., & Tekle, T. A. (2019). Practice of over-the-counter dispensary of antibiotics for childhood illnesses in Addis Ababa, Ethiopia: a simulated patient encounter study. Antimicrobial Resistance and Infection Control, 8(1), 119. doi:10.1186/s13756-019-0571-x
29. Kagoya, E. K., Van Royen, K., Waako, P., Van Royen, P., Iramiot, J. S., Obakiro, S. B., ... & Anthierens, S. (2021). Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study. Journal of global antimicrobial resistance, 25, 66-71.
30. Lindberg, B. H., Gjelstad, S., Foshaug, M., & Høye, S. (2017). Antibiotic prescribing for acute respiratory tract infections in Norwegian primary care out-of-hours service. Scandinavian Journal of Primary Health Care, 35(2), 178-185. https://doi.org/10.1080/02813432.2017.1333301
31. Machowska, A., & Stålsby Lundborg, C. (2018). Drivers of irrational use of antibiotics in Europe. International Journal of Environmental Research and Public Health, 16(1), 27. doi:10.3390/ijerph16010027
32. Markovic-Pekovic, V., Grubica, N., Burger, J., Bojanic, L., & Godman, B. (2017). Initiatives to reduce nonprescription sales and dispensing of antibiotics: Findings and implications. Journal of Research in Pharmacy Practice, 6(2), 120–125. doi:10.4103/jrpp.JRPP_17_12
33. Mboya, E. A., Sanga, L. A., & Ngocho, J. S. (2018). Irrational use of antibiotics in the Moshi Municipality Northern Tanzania: a cross sectional study. The Pan African Medical Journal, 31, 165. doi:10.11604/pamj.2018.31.165.15991
34. McCloskey, A. P., Malabar, L., McCabe, P. G., Gitsham, A., & Jarman, I. (2023). Antibiotic prescribing trends in primary care 2014-2022. Research in Social & Administrative Pharmacy: RSAP, 19(8), 1193–1201. doi:10.1016/j.sapharm.2023.05.001
35. Mirha, H.-T., Ali, S. H., Aamar, H., Sadiq, M., Tharwani, Z. H., Habib, Z., & Malikzai, A. (2024). The impact of antibiotic resistance on the rampant spread of infectious diseases in Pakistan: Insights from a narrative review. Health Science Reports, 7(4), e2050. doi:10.1002/hsr2.2050
36. Mustafa, Z. U., Nazir, M., Majeed, H. K., Salman, M., Hayat, K., Khan, A. H., … Godman, B. (2022). Exploring knowledge of antibiotic use, resistance, and stewardship programs among pharmacy technicians serving in ambulatory care settings in Pakistan and the implications. Antibiotics (Basel, Switzerland), 11(7), 921. doi:10.3390/antibiotics11070921
37. Nair, M., Tripathi, S., Mazumdar, S., Mahajan, R., Harshana, A., Pereira, A., … Burza, S. (2019). Knowledge, attitudes, and practices related to antibiotic use in Paschim Bardhaman District: A survey of healthcare providers in West Bengal, India. PloS One, 14(5),e0217818.doi:10.1371/journal.pone.0217818
38. Ndir, A., Diop, A., Ka, R., Faye, P. M., Dia-Badiane, N. M., Ndoye, B., & Astagneau, P. (2016). Infections caused by extended-spectrum beta-lactamases producing Enterobacteriaceae: clinical and economic impact in patients hospitalized in 2 teaching hospitals in Dakar, Senegal. Antimicrobial Resistance and Infection Control, 5(1). doi:10.1186/s13756-016-0114-7
39. Patel, P., Wermuth, H. R., Calhoun, C., & Hall, G. A. (2023). Antibiotics. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK535443/
40. Rocha, V., Estrela, M., Neto, V., Roque, F., Figueiras, A., & Herdeiro, M. T. (2022). Educational interventions to reduce prescription and dispensing of antibiotics in primary care: A systematic review of economic impact. Antibiotics (Basel, Switzerland), 11(9), 1186. doi:10.3390/antibiotics11091186
41. Siddique, N., Hussain, A., & Malik, M. (2020). Evaluation of prescribing pattern at basic health care facilities of Islamabad Pakistan. International Journal of Research in Pharmaceutical Sciences 11(3), 3119-3126.
42. Saleh, H. A., Borg, M. A., Stålsby Lundborg, C., & Saliba-Gustafsson, E. A. (2022). General practitioners’, pharmacists’ and parents’ views on antibiotic use and resistance in Malta: an exploratory qualitative study. Antibiotics, 11(5), 661.
43. Sakeena, M. H. F., Bennett, A. A., & McLachlan, A. J. (2018). Non-prescription sales of antimicrobial agents at community pharmacies in developing countries: a systematic review. International journal of antimicrobial agents, 52(6), 771-782.
44. Saliba-Gustafsson, E. A., Dunberger Hampton, A., Zarb, P., Orsini, N., Borg, M. A., & Stalsby Lundborg, C. (2019). Factors associated with antibiotic prescribing in patients with acute respiratory tract complaints in Malta: a 1-year repeated cross-sectional surveillance study. BMJ open, 9(12), e032704. https://doi.org/10.1136/bmjopen-2019-032704
45. Saleem, Z., Haseeb, A., Abuhussain, S. S. A., Moore, C. E., Kamran, S. H., Qamar, M. U., …Godman, B. (2023). Antibiotic susceptibility surveillance in the Punjab province of Pakistan: Findings and implications. Medicina (Kaunas, Lithuania), 59(7). doi:10.3390/medicina59071215
46. Saleem, Z., Hassali, M. A., Godman, B., Versporten, A., Hashmi, F. K., Saeed, H., Saleem, F., Salman, M., Rehman, I. U., & Khan, T. M. (2020). Point prevalence surveys of antimicrobial use: a systematic review and the implications. Expert review of anti-infective therapy, 18(9), 897–910.
47. Saleem, Z., Hassali, M. A., Godman, B., Fatima, M., Ahmad, Z., Sajid, A., ... & Hussain, A. (2020). Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study. Journal of pharmaceutical policy and practice, 13, 1-8.
48. Sarwar, M. R., Saqib, A., Iftikhar, S., & Sadiq, T. (2018). Knowledge of community pharmacists about antibiotics, and their perceptions and practices regarding antimicrobial stewardship: a cross-sectional study in Punjab, Pakistan. Infection and Drug Resistance, 11, 133–145. https://doi.org/10.2147/IDR.S148102
49. Tangcharoensathien, V., Chanvatik, S., & Sommanustweechai, A. (2018). Complex determinants of inappropriate use of antibiotics. Bulletin of the World Health Organization, 96(2), 141–144. https://doi.org/10.2471/BLT.17.199687
50. World health organization (WHO). (n.d.). Retrieved 28 May 2024, from http://www.who.int
51. Zapata-Cachafeiro, M., Pineiro-Lamas, M., Guinovart, M. C., Lopez-Vazquez, P., Vazquez-Lago, J. M., & Figueiras, A. (2019). Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study. Journal of Antimicrobial Chemotherapy, 74(2), 511-514.
52. Zanichelli, V., Sharland, M., Cappello, B., Moja, L., Getahun, H., Pessoa-Silva, C., Sati, H., van Weezenbeek, C., Balkhy, H., Simão, M., Gandra, S., & Huttner, B. (2023). The WHO AWaRe (Access, Watch, Reserve) antibiotic book and prevention of antimicrobial resistance [Livre sur les antibiotiques AWaRe (Access, Watch, Reserve) de l'OMS et prévention de la résistance aux antimicrobiens]. Bulletin of the World Health Organization, 101(4), 290–296. https://doi.org/10.2471/BLT.22.288614
53. Zawahir, S., Lekamwasam, S., & Aslani, P. (2019). A cross-sectional national survey of community pharmacy staff: Knowledge and antibiotic provision. PloS one, 14(4),
2. Ahmed, H., Bhimani, S., Khanum, I., Khan, A., Khetpal, A., Abbas, M. A., … Makhdoom, I. U.-H. M. (2020). Knowledge, attitude and perception survey of doctors regarding antibiotic use and resistance in Karachi, Pakistan. JPMA. The Journal of the Pakistan Medical Association, 70(6), 1023–1028. doi:10.5455/JPMA.6239
3. Ahmad, T., Khan, F. U., Ali, S., Rahman, A. U., & Ali Khan, S. (2022). Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client’s study. PLoS One, 17(2), e0263756.
4. Afzal, S., Khan, F. U., Aqeel, M. T., Ullah, M., Bajwa, M., Akhtar, M., & Majid, M. (2024). Impact of a pharmacist-led educational intervention on knowledge, attitude, and practice toward the rational use of antibiotics among healthcare workers in a secondary care hospital in Punjab, Pakistan. Frontiers in Pharmacology, 14, 1327576.
5. Akhund, R., Jamshed, F., Jaffry, H. A., Hanif, H., & Fareed, S. (2019). Knowledge and attitude of general Pakistani population towards antibiotic resistance. Cureus, 11(3).
6. Alkadhimi, A., Dawood, O. T., & Hassali, M. A. (2020). Dispensing of antibiotics in community pharmacy in Iraq: a qualitative study. Pharmacy Practice, 18(4), 2095. doi:10.18549/PharmPract.2020.4.2095
7. Atif, M., Asghar, S., Mushtaq, I., & Malik, I. (2020). Community pharmacists as antibiotic stewards: A qualitative study exploring the current status of Antibiotic Stewardship Program in Bahawalpur, Pakistan. Journal of infection and public health, 13(1), 118–124. https://doi.org/10.1016/j.jiph.2019.07.003
8. Antimicrobial resistance. (2023.). Retrieved 15 June 2024, from https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
9. Aziz, M. M., Haider, F., Rasool, M. F., Hashmi, F. K., Bahsir, S., Li, P., ... & Fang, Y. (2021). Dispensing of non-prescribed antibiotics from community pharmacies of Pakistan: A cross-sectional survey of pharmacy staff’s opinion. Antibiotics, 10(5), 482.
10. Aziz, M. M., & Fang, Y. (2019). Pakistan should immediately curb the sale of non‐prescribed antibiotics from community pharmacies. The International Journal of Health Planning and Management, 34(2), e1376-e1377.
11. Auta, A., Hadi, M. A., Oga, E., Adewuyi, E. O., Abdu-Aguye, S. N., Adeloye, D., ... & Morgan, D. J. (2019). Global access to antibiotics without prescription in community pharmacies: a systematic review and meta-analysis. Journal of Infection, 78(1), 8-18.
12. Belachew, S. A., Hall, L., & Selvey, L. A. (2022). Community drug retail outlet staff’s knowledge, attitudes and practices towards non-prescription antibiotics use and antibiotic resistance in the Amhara region, Ethiopia with a focus on non-urban towns. Antimicrobial Resistance and Infection Control, 11(1), 64. doi:10.1186/s13756-022-01102-1
13. Bianco, A., Licata, F., Trovato, A., Napolitano, F., & Pavia, M. (2021). Antibiotic-dispensing practice in community pharmacies: Results of a cross-sectional study in Italy. Antimicrobial Agents and Chemotherapy, 65(6). doi:10.1128/AAC.02729-20
14. Browne, A. J., Chipeta, M. G., Haines-Woodhouse, G., Kumaran, E. P. A., Hamadani, B. H. K., Zaraa, S., … Dolecek, C. (2021). Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study. The Lancet. Planetary Health, 5(12), e893–e904. doi:10.1016/s2542-5196(21)00280-1
15. Cadogan, C. A., & Hughes, C. M. (2021). On the frontline against COVID-19: Community pharmacists’ contribution during a public health crisis. Research in Social and Administrative Pharmacy, 17(1), 2032-2035.
16. Chukwu, E. E., Oladele, D. A., Enwuru, C. A., Gogwan, P. L., Abuh, D., Audu, R. A., & Ogunsola, F. T. (2021). Antimicrobial resistance awareness and antibiotic prescribing behavior among healthcare workers in Nigeria: a national survey. BMC Infectious Diseases, 21(1), 22. https://doi:10.1186/s12879-020-05689-x
17. Dyar, O. J., Beovic, B., Vlahovic-Palčevski, V., Verheij, T., Pulcini, C., & on behalf of ESGAP (the ESCMID [European Society of Clinical Microbiology and Infectious Diseases] Study Group for Antibiotic Policies) (2016). How can we improve antibiotic prescribing in primary care?. Expert review of anti-infective therapy, 14(4), 403–413. https://doi.org/10.1586/14787210.2016.1151353
18. Elliott, V. (2018). Thinking about the coding process in qualitative data analysis. Qualitative report, 23(11).
19. Friese, S., Soratto, J., & Pires, D. (2018). Carrying out a computer-aided thematic content analysis with ATLAS. IWMI Working Papers, 18.
20. Gajdacs, M., Paulik, E., & Szabo, A. (2020). Knowledge, attitude and practice of community pharmacists regarding antibiotic use and infectious diseases: a cross-sectional survey in Hungary (KAPPhA-HU). Antibiotics, 9(2), 41.
21. Gould, K. (2016). Antibiotics: from prehistory to the present day. The Journal of Antimicrobial Chemotherapy, 71(3), 572–575. doi:10.1093/jac/dkv484
22. Gillani, A. H., Chang, J., Aslam, F., Saeed, A., Shukar, S., Khanum, F., … Fang, Y. (2020). Public knowledge, attitude, and practice regarding antibiotics use in Punjab, Pakistan: a cross-sectional study. Expert Review of Anti-Infective Therapy, 19(3), 399–411. https://doi.org/10.1080/14787210.2021.1823216
23. Hutchings, M. I., Truman, A. W., & Wilkinson, B. (2019). Antibiotics: past, present and future. Current Opinion in Microbiology, 51, 72–80. doi:10.1016/j.mib.2019.10.008
24. Imtiaz, F. , Hafeez, A., Ashraf, F.,& Imtiaz, H. (2017). Antibiotic Dispensing & Prescription Pattern in Pharmacies of Islamabad & Rawalpindi: Pakistan. International Journal of Collaborative Research on Internal Medicine & Public Health, 9(5), 683-692.
25. Khan, F. U., Khan, F. U., Hayat, K., Ahmad, T., Khan, A., Chang, J., … Fang, Y. (2021). Knowledge, attitude, and practice on antibiotics and its resistance: A two-phase mixed-methods online study among Pakistani community pharmacists to promote rational antibiotic use. International Journal of Environmental Research and Public Health, 18(3), 1320. doi:10.3390/ijerph18031320
26. Khan, F. U., Khan, F. U., Hayat, K., Chang, J., Saeed, A., Khan, Z., … Fang, Y. (2020). Knowledge, attitude and practices among consumers toward antibiotics use and antibiotic resistance in Swat, Khyber-Pakhtunkhwa, Pakistan. Expert Review of Anti-Infective Therapy, 18(9), 937–946. https://doi.org/10.1080/14787210.2020.1769477
27. Khan, F. U., and Fang, Y. (2021). Effectiveness of Pharmacist-Led Brief Educational Intervention for Adherence to the Antibiotics for Lower Respiratory Tract Infections (EATSA) in Post-Conflict Rural Areas of Pakistan: Study Protocol for a Randomized Controlled Trial. Antibiotics (Basel) 10, 1147. doi:10.3390/antibiotics10101147
28. Koji, E. M., Gebretekle, G. B., & Tekle, T. A. (2019). Practice of over-the-counter dispensary of antibiotics for childhood illnesses in Addis Ababa, Ethiopia: a simulated patient encounter study. Antimicrobial Resistance and Infection Control, 8(1), 119. doi:10.1186/s13756-019-0571-x
29. Kagoya, E. K., Van Royen, K., Waako, P., Van Royen, P., Iramiot, J. S., Obakiro, S. B., ... & Anthierens, S. (2021). Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study. Journal of global antimicrobial resistance, 25, 66-71.
30. Lindberg, B. H., Gjelstad, S., Foshaug, M., & Høye, S. (2017). Antibiotic prescribing for acute respiratory tract infections in Norwegian primary care out-of-hours service. Scandinavian Journal of Primary Health Care, 35(2), 178-185. https://doi.org/10.1080/02813432.2017.1333301
31. Machowska, A., & Stålsby Lundborg, C. (2018). Drivers of irrational use of antibiotics in Europe. International Journal of Environmental Research and Public Health, 16(1), 27. doi:10.3390/ijerph16010027
32. Markovic-Pekovic, V., Grubica, N., Burger, J., Bojanic, L., & Godman, B. (2017). Initiatives to reduce nonprescription sales and dispensing of antibiotics: Findings and implications. Journal of Research in Pharmacy Practice, 6(2), 120–125. doi:10.4103/jrpp.JRPP_17_12
33. Mboya, E. A., Sanga, L. A., & Ngocho, J. S. (2018). Irrational use of antibiotics in the Moshi Municipality Northern Tanzania: a cross sectional study. The Pan African Medical Journal, 31, 165. doi:10.11604/pamj.2018.31.165.15991
34. McCloskey, A. P., Malabar, L., McCabe, P. G., Gitsham, A., & Jarman, I. (2023). Antibiotic prescribing trends in primary care 2014-2022. Research in Social & Administrative Pharmacy: RSAP, 19(8), 1193–1201. doi:10.1016/j.sapharm.2023.05.001
35. Mirha, H.-T., Ali, S. H., Aamar, H., Sadiq, M., Tharwani, Z. H., Habib, Z., & Malikzai, A. (2024). The impact of antibiotic resistance on the rampant spread of infectious diseases in Pakistan: Insights from a narrative review. Health Science Reports, 7(4), e2050. doi:10.1002/hsr2.2050
36. Mustafa, Z. U., Nazir, M., Majeed, H. K., Salman, M., Hayat, K., Khan, A. H., … Godman, B. (2022). Exploring knowledge of antibiotic use, resistance, and stewardship programs among pharmacy technicians serving in ambulatory care settings in Pakistan and the implications. Antibiotics (Basel, Switzerland), 11(7), 921. doi:10.3390/antibiotics11070921
37. Nair, M., Tripathi, S., Mazumdar, S., Mahajan, R., Harshana, A., Pereira, A., … Burza, S. (2019). Knowledge, attitudes, and practices related to antibiotic use in Paschim Bardhaman District: A survey of healthcare providers in West Bengal, India. PloS One, 14(5),e0217818.doi:10.1371/journal.pone.0217818
38. Ndir, A., Diop, A., Ka, R., Faye, P. M., Dia-Badiane, N. M., Ndoye, B., & Astagneau, P. (2016). Infections caused by extended-spectrum beta-lactamases producing Enterobacteriaceae: clinical and economic impact in patients hospitalized in 2 teaching hospitals in Dakar, Senegal. Antimicrobial Resistance and Infection Control, 5(1). doi:10.1186/s13756-016-0114-7
39. Patel, P., Wermuth, H. R., Calhoun, C., & Hall, G. A. (2023). Antibiotics. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK535443/
40. Rocha, V., Estrela, M., Neto, V., Roque, F., Figueiras, A., & Herdeiro, M. T. (2022). Educational interventions to reduce prescription and dispensing of antibiotics in primary care: A systematic review of economic impact. Antibiotics (Basel, Switzerland), 11(9), 1186. doi:10.3390/antibiotics11091186
41. Siddique, N., Hussain, A., & Malik, M. (2020). Evaluation of prescribing pattern at basic health care facilities of Islamabad Pakistan. International Journal of Research in Pharmaceutical Sciences 11(3), 3119-3126.
42. Saleh, H. A., Borg, M. A., Stålsby Lundborg, C., & Saliba-Gustafsson, E. A. (2022). General practitioners’, pharmacists’ and parents’ views on antibiotic use and resistance in Malta: an exploratory qualitative study. Antibiotics, 11(5), 661.
43. Sakeena, M. H. F., Bennett, A. A., & McLachlan, A. J. (2018). Non-prescription sales of antimicrobial agents at community pharmacies in developing countries: a systematic review. International journal of antimicrobial agents, 52(6), 771-782.
44. Saliba-Gustafsson, E. A., Dunberger Hampton, A., Zarb, P., Orsini, N., Borg, M. A., & Stalsby Lundborg, C. (2019). Factors associated with antibiotic prescribing in patients with acute respiratory tract complaints in Malta: a 1-year repeated cross-sectional surveillance study. BMJ open, 9(12), e032704. https://doi.org/10.1136/bmjopen-2019-032704
45. Saleem, Z., Haseeb, A., Abuhussain, S. S. A., Moore, C. E., Kamran, S. H., Qamar, M. U., …Godman, B. (2023). Antibiotic susceptibility surveillance in the Punjab province of Pakistan: Findings and implications. Medicina (Kaunas, Lithuania), 59(7). doi:10.3390/medicina59071215
46. Saleem, Z., Hassali, M. A., Godman, B., Versporten, A., Hashmi, F. K., Saeed, H., Saleem, F., Salman, M., Rehman, I. U., & Khan, T. M. (2020). Point prevalence surveys of antimicrobial use: a systematic review and the implications. Expert review of anti-infective therapy, 18(9), 897–910.
47. Saleem, Z., Hassali, M. A., Godman, B., Fatima, M., Ahmad, Z., Sajid, A., ... & Hussain, A. (2020). Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study. Journal of pharmaceutical policy and practice, 13, 1-8.
48. Sarwar, M. R., Saqib, A., Iftikhar, S., & Sadiq, T. (2018). Knowledge of community pharmacists about antibiotics, and their perceptions and practices regarding antimicrobial stewardship: a cross-sectional study in Punjab, Pakistan. Infection and Drug Resistance, 11, 133–145. https://doi.org/10.2147/IDR.S148102
49. Tangcharoensathien, V., Chanvatik, S., & Sommanustweechai, A. (2018). Complex determinants of inappropriate use of antibiotics. Bulletin of the World Health Organization, 96(2), 141–144. https://doi.org/10.2471/BLT.17.199687
50. World health organization (WHO). (n.d.). Retrieved 28 May 2024, from http://www.who.int
51. Zapata-Cachafeiro, M., Pineiro-Lamas, M., Guinovart, M. C., Lopez-Vazquez, P., Vazquez-Lago, J. M., & Figueiras, A. (2019). Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study. Journal of Antimicrobial Chemotherapy, 74(2), 511-514.
52. Zanichelli, V., Sharland, M., Cappello, B., Moja, L., Getahun, H., Pessoa-Silva, C., Sati, H., van Weezenbeek, C., Balkhy, H., Simão, M., Gandra, S., & Huttner, B. (2023). The WHO AWaRe (Access, Watch, Reserve) antibiotic book and prevention of antimicrobial resistance [Livre sur les antibiotiques AWaRe (Access, Watch, Reserve) de l'OMS et prévention de la résistance aux antimicrobiens]. Bulletin of the World Health Organization, 101(4), 290–296. https://doi.org/10.2471/BLT.22.288614
53. Zawahir, S., Lekamwasam, S., & Aslani, P. (2019). A cross-sectional national survey of community pharmacy staff: Knowledge and antibiotic provision. PloS one, 14(4),
Article Sidebar
Published
Aug 20, 2024
Article Details
How to Cite
Dr. Waleed Raza, Dr. Eliza Shahid, Dr. Qamar Zaman Phull, Dr. Ghulam Mustafa Dahri, Dr. Shujaullah Talib, & Dr. Khizar Rashid. (2024). AWARENESS AMONGST SERVICE PROVIDERS AND PATIENTS REGARDING THE USE AND DISPENSE OF ANTIBIOTICS A CROSS-CITY ANALYSIS IN PAKISTAN. Journal of Population Therapeutics and Clinical Pharmacology, 31(8), 1982-2004. https://doi.org/10.53555/0ceq9x35
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Dr. Waleed Raza
MSPH, Health Services Academy Islamabad, Pakistan.
Dr. Eliza Shahid
Pharmacist, MSPH, Health Services Academy Islamabad, Pakistan.
Dr. Qamar Zaman Phull
Assistant Professor Pharmacology, Bilawal Medical College for boys (LUMHS) Jamshoro, Pakistan.
Dr. Ghulam Mustafa Dahri
Professor Pharmacology, People's University of Medical & Health Science's for Women Nawabshah, Pakistan
Dr. Shujaullah Talib
Assistant Professor Pharmacology, Mohammad Medical and Dental College (MMDC) Mirpurkhas, Pakistan
Dr. Khizar Rashid
MBBS, Khyber Medical University Peshawar, Pakistan
How to Cite
Dr. Waleed Raza, Dr. Eliza Shahid, Dr. Qamar Zaman Phull, Dr. Ghulam Mustafa Dahri, Dr. Shujaullah Talib, & Dr. Khizar Rashid. (2024). AWARENESS AMONGST SERVICE PROVIDERS AND PATIENTS REGARDING THE USE AND DISPENSE OF ANTIBIOTICS A CROSS-CITY ANALYSIS IN PAKISTAN. Journal of Population Therapeutics and Clinical Pharmacology, 31(8), 1982-2004. https://doi.org/10.53555/0ceq9x35