Pharmacists' Knowledge, Attitude and Practice Regarding the Dispensing of Antibiotics without Prescription in Tanzania: An Explorative Cross-Sectional Study

Inappropriate use of antibiotics has been reported to contribute to the emergence and increase of antimicrobial resistance (AMR) in the world. The pharmacist has the responsibility to supervise the dispensing of antibiotics with prescriptions to ensure rational use. An online semi-structured questionnaire was shared with approximately 1100 licensed pharmacists in Tanzania. Study data were collected and managed using REDCap electronic data capture tools before use for analysis. Of the 226 (20.5%) received responses, 197 had given consent and provided complete surveys. Notably, 153 (77.7%) of the 197 pharmacists had excellent knowledge about the legal requirements for dispensing antibiotics and the AMR challenge. Of the 197 surveyed pharmacists, 143 (72.6%) admitted to dispensing antibiotics without a prescription in their daily practice. Notably, 84.1% (37/44) of pharmacists with masters or PhD education were more likely to dispense without a prescription compared to 69.3% (106/153) among bachelor holders (p-value = 0.04). The reasons for administering antibiotics without a prescription included the pharmacy business looking for more profit, patient failure to obtain a prescription and the lack of stringent inspection of pharmacies by the regulatory authorities. Penicillins, macrolides and fluoroquinolones were the classes of antibiotics most commonly dispensed without a prescription. Stringent inspections by the regulatory authorities should detect and reduce dispensing antibiotics without a prescription. The community should be educated on the importance of medication prescription from a qualified medical practitioner.