Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.

<h4>Background</h4>Unregulated antimicrobial use is common in both hospital and community settings of low- and middle-income countries (LMICs). However, discrete data regarding the use/misuse of antimicrobials at pharmacies in LMICs are limited. This study was conducted to understand kno...

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Main Authors: Nistha Shrestha, Sulochana Manandhar, Nhukesh Maharjan, Devina Twati, Sabina Dongol, Buddha Basnyat, Stephen Baker, Abhilasha Karkey
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0285287
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author Nistha Shrestha
Sulochana Manandhar
Nhukesh Maharjan
Devina Twati
Sabina Dongol
Buddha Basnyat
Stephen Baker
Abhilasha Karkey
author_facet Nistha Shrestha
Sulochana Manandhar
Nhukesh Maharjan
Devina Twati
Sabina Dongol
Buddha Basnyat
Stephen Baker
Abhilasha Karkey
author_sort Nistha Shrestha
collection DOAJ
description <h4>Background</h4>Unregulated antimicrobial use is common in both hospital and community settings of low- and middle-income countries (LMICs). However, discrete data regarding the use/misuse of antimicrobials at pharmacies in LMICs are limited. This study was conducted to understand knowledge, attitude, and practice of pharmacy employees on antimicrobial dispensing in Nepal.<h4>Methods</h4>We conducted a cross-sectional survey using a structured questionnaire on 801 pharmacy employees working in community and hospital pharmacies located in Lalitpur metropolitan city (LMC) of Kathmandu, Nepal between April 2017 and March 2019.<h4>Results</h4>A majority (92%) of respondents agreed that demand for non-prescription antimicrobials was common. Asking for prescription before dispensing was ranked as the first preference by majority (69%) of participants. Suspected respiratory tract infection was the most common reason demanding for non-prescription antimicrobials with the highest mean rank of 1.5. Azithromycin was the most commonly prescribed and sold antimicrobial, as reported by 46% and 48% of participants respectively. A majority (87%) of respondents agreed on antimicrobial resistance (AMR) to be a global public health threat; and misuse/overuse of antimicrobials was perceived as the most common cause of AMR with a mean rank of 1.93.<h4>Conclusion</h4>Our study revealed that unfounded dispensing and use of antimicrobials is prevalent among pharmacies in Kathmandu, Nepal. This over reliance on antimicrobials, notably azithromycin, may escalate burden of AMR. We identified several drivers of inappropriate antimicrobial dispensing practice in pharmacies, which will aid public health authorities in addressing these issues. Further studies considering role of other stakeholders, such as doctors, veterinarians, general public, and policy makers are required to obtain a more holistic perspectives on practices of antimicrobial use so to curb the extant AMR crisis.
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spelling doaj.art-d590e17da22a41b4bb5a6e48085f272f2023-05-14T05:31:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01185e028528710.1371/journal.pone.0285287Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.Nistha ShresthaSulochana ManandharNhukesh MaharjanDevina TwatiSabina DongolBuddha BasnyatStephen BakerAbhilasha Karkey<h4>Background</h4>Unregulated antimicrobial use is common in both hospital and community settings of low- and middle-income countries (LMICs). However, discrete data regarding the use/misuse of antimicrobials at pharmacies in LMICs are limited. This study was conducted to understand knowledge, attitude, and practice of pharmacy employees on antimicrobial dispensing in Nepal.<h4>Methods</h4>We conducted a cross-sectional survey using a structured questionnaire on 801 pharmacy employees working in community and hospital pharmacies located in Lalitpur metropolitan city (LMC) of Kathmandu, Nepal between April 2017 and March 2019.<h4>Results</h4>A majority (92%) of respondents agreed that demand for non-prescription antimicrobials was common. Asking for prescription before dispensing was ranked as the first preference by majority (69%) of participants. Suspected respiratory tract infection was the most common reason demanding for non-prescription antimicrobials with the highest mean rank of 1.5. Azithromycin was the most commonly prescribed and sold antimicrobial, as reported by 46% and 48% of participants respectively. A majority (87%) of respondents agreed on antimicrobial resistance (AMR) to be a global public health threat; and misuse/overuse of antimicrobials was perceived as the most common cause of AMR with a mean rank of 1.93.<h4>Conclusion</h4>Our study revealed that unfounded dispensing and use of antimicrobials is prevalent among pharmacies in Kathmandu, Nepal. This over reliance on antimicrobials, notably azithromycin, may escalate burden of AMR. We identified several drivers of inappropriate antimicrobial dispensing practice in pharmacies, which will aid public health authorities in addressing these issues. Further studies considering role of other stakeholders, such as doctors, veterinarians, general public, and policy makers are required to obtain a more holistic perspectives on practices of antimicrobial use so to curb the extant AMR crisis.https://doi.org/10.1371/journal.pone.0285287
spellingShingle Nistha Shrestha
Sulochana Manandhar
Nhukesh Maharjan
Devina Twati
Sabina Dongol
Buddha Basnyat
Stephen Baker
Abhilasha Karkey
Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.
PLoS ONE
title Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.
title_full Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.
title_fullStr Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.
title_full_unstemmed Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.
title_short Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal.
title_sort perspectives of pharmacy employees on an inappropriate use of antimicrobials in kathmandu nepal
url https://doi.org/10.1371/journal.pone.0285287
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