Antimicrobial stewardship in community pharmacies in Uyo, Akwa Ibom State: practices, barriers, and facilitators

Objective: To evaluate the practices, barriers, and facilitators related to antimicrobial stewardship (AMS) in community pharmacies (CPs). Design: Cross-sectional study. Setting: CPs in Uyo, Akwa Ibom State, Nigeria. Participants: One hundred and twelve pharmacists working in CPs, who had been practicing for at least six months and gave informed consent to participate, were surveyed. Methods: Potential participants were approached at their CPs during working hours and the study's objectives explained to them. Data were collected using a 31-item self-administered questionnaire from October to November 2023 and analyzed with SPSS version 25.0. Result: Participants were predominantly male (61.6%). Eighty-seven (77.7%) indicated that they often/always encourage patients to run a culture/sensitivity test before taking antibiotics. Most (95.5%) indicated that their choice of antibiotics is based on such results. The most frequently cited barriers to implementing AMS in CPs were limited access to patient records (93.8%), unrestricted patient access to antimicrobials without a prescription (90.1%), and physicians' resistance to pharmacists intervening in antibiotic selection (58.0%) or the dose/duration of prescribed antibiotics (50.9%). The most commonly reported facilitators of AMS were increased availability of pharmacy education programs on AMS (92.9%), improved access to patients' clinical/laboratory data (88.4%), improved collaboration with physicians in hospitals (85.7%), and public awareness initiatives emphasizing the role of community pharmacists in AMS (85.7%). Conclusion: Participants reported generally favorable AMS practices. However, tailored AMS education programs for pharmacists and the general public, along with stronger collaboration between pharmacists and physicians and between CPs and hospitals are recommended.