Knowledge, attitudes and practices survey on antimicrobial resistance and stewardship among pharmacy healthcare workers

Overview: 

Antimicrobial resistance (AMR) is a growing global health concern that hits low- and middle-income countries the hardest, where antibiotics are often overused or misused. Pharmacists and pharmacy workers play a vital role in ensuring these medicines are used responsibly, making their understanding and day-to-day practices crucial in slowing the spread of AMR. 

This Africa CDC study, supported by One Health Trust, explores how pharmacy workers across 28 African countries understand and implement antimicrobial stewardship (AMS) principles. Using survey data, they analyzed pharmacy workers’ knowledge, attitudes, and practices (KAP) around AMR and AMS, and the key factors that shape how antibiotics are dispensed. 

The Question: 

What are the practices and attitudes, and knowledge levels of AMS among pharmacy healthcare workers dispensing antibiotics across African countries, and what factors influence their dispensing behavior? 

The Findings:  

Researchers conducted an online survey among healthcare workers involved in dispensing antimicrobials. Responses were analyzed to assess levels of KAP, with a 70 percent score used as the benchmark for good KAP. Logistic regression was then used to identify factors associated with better or poorer KAP scores.  

Out of 908 eligible respondents from 28 countries: 

• 71.3 percent had good knowledge of AMR and AMS. 

• 59.9 percent showed positive attitudes toward responsible antimicrobial use. 

• Only 41.6 percent demonstrated good practices in antimicrobial stewardship. 

• Patient demands and pharmaceutical company influence were key drivers of inappropriate antibiotic dispensing. 

• Licensed pharmacists were significantly more knowledgeable than pharmacy technicians. 

• Female dispensers were more likely to have positive attitudes than males. 

• Public-sector dispensers showed better AMS practices than those in private facilities. 

Overall, better knowledge was strongly linked to more positive attitudes and better practices. 

The study highlights important gaps in knowledge and practices around AMR among pharmacy staff, especially those without formal training.  

Read the article in BMJ Global Health here.