Knowledge, Attitudes, and Practices of Community Pharmacy Professionals on Poultry Antibiotic Dispensing, Use, and Bacterial Antimicrobial Resistance in Zambia: Implications on Antibiotic Stewardship and WHO AWaRe Classification of Antibiotics

Steward Mudenda; Moses Mukosha; Brian Godman; Joseph Fadare; Sydney Malama; Musso Munyeme; Christabel Nang'andu Hikaambo; Aubrey Chichonyi Kalungia; Audrey Hamachila; Henson Kainga; Flavien Nsoni Bumbangi; Victor Daka; Ruth Lindizyani Mfune; Geoffrey Mainda; Webrod Mufwambi; Prudence Mpundu; Maisa Kasanga; Shereen Ahmed Mohammed Saad; John Bwalya Muma

doi:10.3390/antibiotics11091210

Knowledge, Attitudes, and Practices of Community Pharmacy Professionals on Poultry Antibiotic Dispensing, Use, and Bacterial Antimicrobial Resistance in Zambia: Implications on Antibiotic Stewardship and WHO AWaRe Classification of Antibiotics

Antibiotics (Basel). 2022 Sep 7;11(9):1210. doi: 10.3390/antibiotics11091210.

Authors

Steward Mudenda^{1

2

3}, Moses Mukosha¹, Brian Godman^{4

5

6}, Joseph Fadare⁷, Sydney Malama⁸, Musso Munyeme², Christabel Nang'andu Hikaambo¹, Aubrey Chichonyi Kalungia¹, Audrey Hamachila¹, Henson Kainga^{2

9}, Flavien Nsoni Bumbangi^{2

10}, Victor Daka^{3

11}, Ruth Lindizyani Mfune¹¹, Geoffrey Mainda¹², Webrod Mufwambi¹, Prudence Mpundu¹³, Maisa Kasanga¹⁴, Shereen Ahmed Mohammed Saad^{3

15}, John Bwalya Muma²

Affiliations

¹ Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia.
² Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia.
³ Africa Center of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka P.O. Box 32379, Zambia.
⁴ Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa.
⁵ Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates.
⁶ Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK.
⁷ Department of Pharmacology and Therapeutics, Ekiti State University College of Medicine, Ado-Ekiti 362103, Nigeria.
⁸ Department of Biological Sciences, School of Natural Sciences, University of Zambia, Lusaka P.O. Box 32379, Zambia.
⁹ Department of Veterinary Epidemiology and Public Health, Faculty of Veterinary Medicine, University of Agriculture and Natural Resources, Lilongwe P.O. Box 219, Malawi.
¹⁰ School of Medicine, Eden University, Lusaka P.O. Box 37727, Zambia.
¹¹ Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola P.O. Box 21692, Zambia.
¹² Department of Veterinary Services, Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka P.O. Box 50060, Zambia.
¹³ Department of Environmental and Occupational Health, Levy Mwanawasa Medical University, School of Health Sciences, Lusaka P.O. Box 33991, Zambia.
¹⁴ College of Public Health, Zhengzhou University, Zhengzhou 450001, China.
¹⁵ College of Veterinary Science, University of Bahr El-Ghazal, Wau P.O. Box 10739, South Sudan.

Abstract

Globally, the inappropriate dispensing and use of antibiotics in animals has contributed to the development of bacterial antimicrobial resistance (AMR). In Zambia, there is insufficient information among community pharmacy professionals on antibiotic use (ABU) and AMR in food-producing animals. This study assessed community pharmacy professionals' knowledge, attitudes, and practices regarding poultry antibiotic dispensing, use, and bacterial AMR in the Lusaka district of Zambia. A cross-sectional study was conducted among 178 community pharmacy professionals between February and April 2022 using a semi-structured questionnaire. Data were analyzed using Stata version 17. Of the total participants (n = 178), 51.1% (n = 91) were pharmacists. The most dispensed antibiotic was oxytetracycline, a Watch antibiotic, mainly without prescriptions. Good knowledge of ABU and AMR was associated with work experience for more than one year (p = 0.016), while good practices were associated with male gender (p = 0.039) and work experience of more than one year (p = 0.011). The study found moderate knowledge, positive attitudes, and moderate practices of pharmacy professionals on poultry ABU and AMR. There was high dispensing of poultry antibiotics without prescriptions, which calls for strict implementation of antimicrobial stewardship and surveillance programs in poultry production in Zambia to reduce AMR.

Keywords: AWaRe classification; antibiotic resistance; antibiotic use; antimicrobial resistance; antimicrobial stewardship; attitudes; knowledge; pharmacists; poultry; practices; surveillance.

Grants and funding

5803-ZM/Africa Center of Excellence of Infectious Diseases of Humans and Animals