Antimicrobial Stewardship: Knowledge and Attitudes of Pharmacy Staff on Antibiotic Dispensing Patterns, Use and Resistance in Benin

Abstract

Background: One of the key drivers for the emergence and spread of antimicrobial resistance (AMR) is non-prudent antibiotic use, which results in selection pressure toward relevant bacteria. Pharmacy staffs have pivotal roles in facilitating the prudent use of antibiotics through antimicrobial stewardship programs. Due to limited information in Benin, this study assessed the knowledge and attitudes of pharmacy staffs on antibiotic use and resistance. Materials and Methods: This cross-sectional study was conducted among 159 pharmacy staffs using a structured questionnaire from August 2018 to December 2018 in Benin. Data analysis was done by using Stata version 13.0. Results: Of the 159 participants, 54.8% knew the definition of antibiotic therapy and 66.9% knew the definition of probabilistic antibiotic therapy. The majority (88.1%) of the participants thought that the choice of antibiotics was made according to the pathology, while 60.4% thought that it depended on the pathology and the germ involved. 49.02% of dispensers in pharmacies stated that half of the patients had requested treatment without providing a prescription at the pharmacy. The top three antibiotics that were dispensed without a prescription include amoxicillin (98.1%), cloxacillin (76.7%) and metronidazole (57.2%), all from the Access group of antibiotics. Conclusion: These results underscore the need for educational and training interventions targeting specific professional groups. There is an urgent need for regulatory measures and public awareness through improved antimicrobial stewardship to limit this practice.

Global Strategies to Combat Antimicrobial Resistance: A One Health Perspective

“…In conclusion, we recommend continuous research that improves the awareness, knowledge, attitudes, and practices of individuals on AMU, AMR, and AMS. Some studies have been conducted to promote these issues [48] [154]- [181]. By doing so, these studies and campaigns will contribute towards the attainment of the objectives set by the GAP and NAPs on AMR.…”

Non-prescription sale and dispensing of antibiotics for prophylaxis in broiler chickens in Lusaka District, Zambia: findings and implications on one health

“… 3 , 5 , 7 This may be attributed to inadequate enforcement of regulations resulting in easy access to antibiotics, where people easily buy antibiotics without a prescription, as reported in a study that was conducted in Ghana. 5 The non-prescription sale of antibiotics has also been reported in the human health sector, where there were a 100% non-prescription sale of antibiotics in community pharmacies in Zambia 8 and 76.5% in Benin, 15 respectively. The non-prescription sale of medicines is a global problem with negative impacts on animals, humans and the environment.…”

Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship

“… 21 , 22 This may happen through antimicrobial overprescribing or underprescribing by prescribers, empirical treatment, self-medication and purchasing drugs without a legal prescription. 10 , 23–27 Some determinants affect the choice and attitude towards antimicrobial use (AMU). 28–31 Some factors influence individuals’ choices and attitudes toward AMU, including readily accessible retail pharmacies, which have emerged as the predominant source of outpatient care in Africa.…”

“… 50–53 Despite this understanding, the misuse and overuse of antibiotics persist globally in both healthcare facilities and the community because of the complex interplay between profitability, regulation and the public health challenges associated with antibiotic use. 23 , 54 , 55 …”

“… 56–60 This pressure is noted to be significant in the context of South Africa, among other African countries. 23 , 56 , 61 , 62 Additionally, the inappropriate use of antibiotics has been reported to be due to a lack of: diagnostic tests; poor infection, prevention and control (IPC) practices; insufficient funding; poor vaccine coverage and uptake; illegal drug stores; substandard antibiotics; irresponsible use of laboratory services by clinicians; and a lack of political will. 31 , 63–65 The most inappropriate use of antibiotics is observed in cases of: URTIs; generally self-limited viral infections; acute diarrhoea; and urinary tract infections.…”