Community pharmacists’ knowledge, attitude, and practices towards dispensing antibiotics without prescription (DAwP): a cross-sectional survey in Makkah Province, Saudi Arabia

Muhammad Abdul Hadi, Nedaa Ali Karami, Anhar S. Al-Muwalid, Areej Al-Otabi, Eshtyaq Al-Subahi, Asmaa Bamomen, Mahmoud M.A. Mohamed, Mahmoud E. Elrggal

To evaluate knowledge, attitude and practices of community pharmacists towards dispensing antibiotics without prescription in Makkah province, Saudi Arabia. A cross sectional survey was conducted using a structured, validated and pilot-tested questionnaire between January 2016 and February 2016. A 4-step systematic approach was used to recruit community pharmacists who completed a 28-item questionnaire either in English or Arabic language based on their personal preference. Of the 200 community pharmacists approached, 189 pharmacists completed the questionnaire. More than two thirds (70.5%) of the pharmacists were not aware that DAwP is illegal practice. Lack of patients' willingness to consult physicians for non-serious infections (69.9%) and inability to afford consultation with physician (65.3%) were the most common reasons cited for dispensing antibiotics without prescription. Statistically significant association was found between number of antibiotics dispensed and educating patients about the importance of adherence and completion the full course of antibiotics (P=0.007). In general, community pharmacists have poor understanding about regulations prohibiting the over the counter sales of antibiotics in Saudi Arabia, explaining high rates of DAwP in the country. A multifaceted approach consisting of educational interventions and improving general public's access and affordability to healthcare facilities is required to effectively reduce dispensing antibiotics without prescription and its negative consequences on public health.