Abstract

Title: Pharmacists’ knowledge, attitude and practice regarding the dispensing of antibiotics without a prescription in Tanzania: an explorative cross-sectional study

Authors: Baraka P. Poyongo and Raphael Z. Sangeda

Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Background: Inappropriate use of antibiotics has been reported to contribute to the emergence and increase of antimicrobial resistance (AMR) in the world. Enforcing the dispensing of antibiotics with prescription is a way to promote the rational use of antibiotics and preventing the development and spread of AMR. The pharmacist has the responsibility to supervise the dispensing of antibiotics in pharmacies and ensure its rational use. This study assessed pharmacists’ knowledge, attitude and practice regarding the dispensing of antibiotics without prescription in Tanzania.

Methods: An online semi-structured questionnaire was designed, tested and shared with licensed pharmacists in Tanzania through an invitation link sent in their official WhatsApp groups. An SMS alternative was used contact list from the Pharmacy Council to administer the questionnaire, to pharmacist not subscribed on WhatsApp. Study data were collected and managed using REDCap electronic data capture tools hosted at Muhimbili University of Health
and Allied Sciences, Dar es Salaam, Tanzania. Data were then downloaded and exported into Statistical Package for Social Sciences (SPSS) version 20 for data analysis; Chi-square test was used to test association for categorical data, where a p-value of less than 0.05 was considered statistically significant.

Results: More than 75% of pharmacists had excellent knowledge about the legal requirements for dispensing antibiotics and of the AMR challenge. Of the interviewed pharmacists, seventy-four percent admitted to dispensing antibiotics without a prescription in their daily practice. Notably, 85.7% of pharmacists with high education were more likely to dispense without prescription compared to 69.9% among bachelor holders (p-value = 0.028). The main reasons for administering antibiotics without a prescription were the profitability nature of pharmacy business, a failure of the patient to get a prescription and lack of stringent regulatory authorities.
Penicillins, macrolides and fluoroquinolones were the classes of antibiotics mostly dispensed without a prescription.

Conclusion: Even though pharmacists seem knowledgeable about AMR, they still dispense antibiotics without prescription in Tanzania. The regulatory authorities should make regular inspections in pharmacies to detect this malpractice. The community should be trained on the importance of taking laboratory tests before getting medications for their sickness by a qualified medical practitioner.

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