Knowledge, Attitudes and Practices Related to Antibiotic Use Among Community and Hospital Pharmacists in Galle District, Sri Lanka

Background: Pharmacists’ knowledge about and attitudes towards antibiotic impact on appropriate antibiotic supply. However, this information is lacking in Sri Lanka. Purpose: To evaluate the knowledge, attitudes and practice of antibiotic use and antibiotic resistance (AR) among community pharmacists and hospital pharmacists in Galle District, Sri Lanka. Methods: A cross-sectional study using a self-administered questionnaire was conducted to assess their knowledge about antibiotic use and causes of AR, attitudes towards antibiotic use and dispensing practice. Data were analyzed using descriptive and inferential statistics. Results: Ninety percent of the pharmacists (n=90/100) responded, comprising community pharmacists (n=43) with efficiency qualifications and hospital pharmacists with proficiency (n=45) or B.Pharm (n=2) qualifications. The hospital pharmacists' knowledge about consequences of inappropriate antibiotic use, ineffective treatment (100%) and AR (100%), were significantly higher than community pharmacists’ knowledge (91% and 86%; P=0.048 and 0.010, respectively). The knowledge about AR reasons, for example, antibiotic use for non-bacterial infections, was also significantly higher in hospital pharmacists (92%) than community pharmacists (74%), P=0.030. 84% of respondents had positive responses on all attitude statements. Most of the participants (98%) denied non-prescription antibiotic supply. Overall, greater knowledge about antibiotic use increased the likelihood of higher knowledge about AR (Adj. OR=3.94; 95% CI: 1.57-9.88; P=0.003) and positive attitude towards it (Adj. OR=3.71; 95%CI: 1.54-8.92; P=0.003). Conclusion: Extent of pharmacy qualification could impact the pharmacists’ antibiotic use and AR knowledge. Raising pharmacists' knowledge about antibiotic use may enhance their AR knowledge and attitudes towards it.