Effectiveness of a Training Intervention on Antimicrobial Resistance and Antibiotic Dispensing Patterns among Community Pharmacists

Abstract

Antimicrobial resistance (AMR) poses a significant public health threat globally, with India among the worst affected. Community pharmacists (CPs), as accessible healthcare providers, often dispense antibiotics without prescriptions, contributing to misuse and resistance. Despite their crucial role in antimicrobial stewardship (AMS), few targeted educational initiatives exist in India. This study aimed to assess the impact of a structured educational intervention on the knowledge, attitude, and practice (KAP) of CPs, regarding antibiotic use and AMR. A prospective educational intervention study was conducted over six months involving 87 CPs. A validated KAP questionnaire, developed using WHO and FIP guidelines, was administered pre- and post-intervention. A two-day Continuing Professional Development (CPD) workshop covering AMR, the WHO AWaRe classification, and AMS was conducted. Data were analyzed using SPSS v20.0, applying paired t-tests with p < 0.05 considered statistically significant. A total of 87 CPs participated, predominantly male (59.8%) and aged 21–30 years (51.7%), with most holding a diploma in pharmacy (83.9%) and working in independent pharmacies (65.5%). Pre-intervention, 60.9% of CPs dispensed antibiotics without a prescription, mainly for respiratory infections. Azithromycin and amoxicillin were the most commonly dispensed antibiotics. Post-intervention, knowledge, attitude, and practice scores significantly improved. Recognition of AMR as a public threat rose (27.6% to 42.5%), and awareness of prescription-only antibiotic dispensing improved (35.6% to 89.8%). Attitude and practice also improved, including medical history checks (13.8% to 75.9%) and counselling (13.8% to 65.5%). Structured CPD-based training significantly improved the KAP of CPs. Sustainable AMS in India requires regular training, supportive policy frameworks, and public engagement to empower pharmacists as key stakeholders in combating AMR