Exploring Knowledge of Antibiotic Use, Resistance, and Stewardship Programs among Pharmacy Technicians Serving in Ambulatory Care Settings in Pakistan and the Implications

Abstract

Antimicrobial resistance (AMR) is a leading global health threat, increasing morbidity, mortality, and costs, with excessive and irrational use of antimicrobials contributing to the development of AMR. Consequently, the aims of this study were to evaluate the understanding of antibiotic use, AMR, and antimicrobial stewardship programs (ASPs) among pharmacy technicians serving in ambulatory healthcare settings in Pakistan. A cross-sectional survey was conducted among pharmacy technicians serving in 144 ambulatory care settings in seven districts of Punjab province using a validated questionnaire. Overall, 376 technicians completed the survey (85.8% response rate). The majority were men (89.1%), aged 25–35 years (45.1%), serving in emergency departments (43.9%) and filling 31–60 prescriptions per day (37.5%). Most (79.5%) knew that antibiotics were one of the most frequently prescribed drug classes, while 59.8% believed antibiotics for common colds did not speed up recovery. Inadequate duration (59.6%) and inadequate dosages (57.7%) of antibiotic therapy were reported as the leading causes of AMR. Terms including ‘superbugs’, ‘multidrug resistance’, and ‘extensively drug resistance’ were known to 42.0%, 25.3%, and 20.7% of participants, respectively; however, <10% knew about ASPs, including their core elements and purpose. Our study revealed that pharmacy technicians have adequate awareness of antibiotic use but are currently unaware of AMR and ASPs, which is a concern.

Antibiotic Prescribing Pattern: Pharmacy Staff Knowledge about Antibiotics at Primary Health Care Centers in Riyadh City, Saudi Arabia

“…different healthcare facilities settings. 12,24 The age distribution between respondents was not significant, like in the previous study. 10,12,24 However, there are higher ages of pharmacy technicians because there is an old staff of pharmacy technicians due to holding the pharmacy technician studies.…”

Knowledge, Attitude and Practices of Self-Medication Including Antibiotics among Health Care Professionals during the COVID-19 Pandemic in Pakistan: Findings and Implications

“…This includes knowledge of the AWaRe classification of antibiotics, suggested antibiotics for treating a range of infections in both ambulatory and hospital care with the emphasis on “Access” antibiotics, and the implications for excessive prescribing of “Watch” and “Reserve” antibiotics [ 88 , 89 , 124 ]. This is because there have been concerns with the level of knowledge of these key issues among students and healthcare professionals in LMICs [ 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 ].…”

“…We chose Punjab Province for this study in view of its population size within Pakistan, i.e., accounting for more than half of the population of Pakistan. Furthermore, similar research has been conducted in this province, with this research following on from existing research studies undertaken by the co-authors [ 4 , 50 , 125 , 133 , 138 ].…”

COVID-19 Vaccines Status, Acceptance and Hesitancy among Maintenance Hemodialysis Patients: A Cross-Sectional Study and the Implications for Pakistan and Beyond

“…A pilot study was subsequently conducted prior to the initiation of the full-length study by inviting 20 potential participants. We have successfully used this approach in previous studies where there is no specific validated instrument; however, one can be successfully adapted from previous studies using the experience of the co-authors [ 81 , 82 , 83 , 84 , 85 ]. After incorporating the recommendations/suggestions of the participants in the pilot study, the study instrument had the following three sections: Section-I: This section collected data on the demographics of the study population, hemodialysis-related details and the COVID-19 vaccination status.…”