# Knowledge Deficits Among Community Pharmacists May Drive Antibiotic Resistance in Rural Areas: Evidence from Southern Jordan

## TL;DR

Community pharmacists in southern Jordan lack sufficient knowledge about antibiotics, which may contribute to antibiotic resistance due to poor practices like dispensing antibiotics without prescriptions.

## Contribution

The study reveals significant knowledge and practice gaps among community pharmacists in southern Jordan regarding antimicrobial stewardship and resistance mechanisms.

## Key findings

- 38.6% of pharmacists infrequently dispensed antibiotics without prescriptions.
- 67.4% incorrectly believed antibiotics can cure viral infections like the flu or common cold.
- Only 33.4% firmly rejected non-prescription antibiotic requests.

## Abstract

Background/Objectives: Antimicrobial resistance (AMR) is a major global health issue. Since community pharmacists are frontline health officials regarding the provision and management of antibiotics, it is of great importance to study the knowledge, attitudes, and practices (KAPs) of pharmacists with respect to antimicrobial stewardship (AMS) to formulate specific interventions. In Jordan, where dispensing antibiotics without a prescription is a common situation, this study was designed to assess the KAPs of community pharmacists in southern Jordan on AMR and AMS, the gap in the knowledge base and the practice, and the effect of other variables on antimicrobial education and responsible dispensing. Results: Participant pharmacists (n = 383) confirmed a moderate or lack of knowledge in antibiotic choice, resistance mechanisms, and the basis of stewardship. Despite positive attitudes for AMS, important practice gaps occurred: 38.6% infrequently dispensed antibiotics without prescriptions, 67.4% mistakenly believed that antibiotics may cure viral infections (flu/common cold), and only 33.4% firmly rejected non-prescription antibiotic requests. Knowledge scores were significantly higher among bachelor’s degree pharmacists, public university pharmacists, and urban-working pharmacists. Practice scores were better among master’s degree holders and urban practitioners. Conclusions: This work indicates that the AMS knowledge and practices of pharmacists in the southern Jordanian community are lacking in a severe way, with almost 4 out of 10 having poor behaviors including dispensing non-prescription antibiotics.