Retail Pharmacists’ Practices that Contribute to Antimicrobial Resistance in South West Nigeria.

Abstract

Introduction: Antimicrobial resistance (AMR) accounts for over 700,000 deaths annually and over 263,000 deaths in Nigeria. Objectives: To assess how retail pharmacists’ antibiotic dispensing, purchasing, and disposal practices in South West Region in Nigeria, contribute to antibiotic resistance (ABR) in Nigeria. Method: This is a secondary data analysis of research by Arkland Health Initiative that assessed retail pharmacists’ practices in Nigeria. A subset of the data from the South West region was analysed. Responses collected over a 5-point Likert scale underwent descriptive analysis using SPSS while quotes were analysed using thematic analysis. Results: Almost half (42.7%) of the pharmacists reported dispensing antibiotics without prescription, and only 57.3% always or often performed quality checks to identify substandard or falsified (SF) medicines, which have been associated with AMR. Pharmacists reported never buying medicines not accredited by NAFDAC (53.1%) or from the open market (63.5%), reducing exposure to SF antibiotics. Maximum academic qualifications, years of experience, non-pharmacy ownership of pharmacy, and frequency of consulting ethical guidelines were not statistically associated with pharmacists dispensing antibiotics without prescriptions (P-value > 0.05). Findings revealed that non-prescription antibiotic dispensing (NPAD) was primarily driven by economic reasons, as well as the fear of losing customers, managerial pressure, and poor regulation. This research is limited by a small sample size (n=96) caution is advised in generalising findings. Conclusion: Providing grants to manage retail pharmacies, training on antimicrobial stewardship, imposing sanctions on pharmacists who dispense antibiotics without prescription, and improved regulation are recommended to limit NPAD.