Pharmacists’ perception of their challenges at work, focusing on antimicrobial resistance: A qualitative study from Bangladesh
Open accessAbstract
Background: The indiscriminate use of antimicrobial medicines has contributed to the development of microorganisms’ resistance to antibiotics. Antimicrobial resistance (AMR) is a major global health problem and is most acute in countries that have a weak health care and regulatory system and a high burden of infectious diseases, such as Bangladesh. Due to shortages of physicians available to diagnose and prescribe appropriate antibiotics, people with ailments in Bangladesh are forced to contact various types of health care services, including retail pharmacies, that lack supervision by qualified medical personnel. It is unknown how pharmacists perceive the AMR situation and the related challenges they face.Objective: The aim of the study was to understand retail pharmacist’s perceptions regarding AMR.Method: A qualitative study design was used, and in-depth interviews were held with retail pharmacists in Dhaka.Results: The participants demonstrated a variety of concerns regarding AMR. They considered that self-medication, old prescriptions, lack of regulations and supervision, and readily available antibiotics were the main factors that contributed to the misuse of antimicrobial medicines and the development of AMR.Conclusions: To control the further spread of AMR in Bangladesh, there is a need to work at several levels of the health system simultaneously. Initiatives could include establishment of the ‘Model Pharmacy’ programme nationwide, increasing and widening the focus on AMR in pharmacists’ education, ensuring the implementation of government guidelines on AMR, increasing public awareness of the consequences of antimicrobial use, and surveillance and monitoring of regulations and progress. A multipronged strategy is necessary not only for better AMR control but also for investment in a system that is well equipped to provide equitable care in the face of both existing and new health challenges.
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Recent reports show that pharmacists dispensed antibiotics without prescriptions or consumers visit pharmacies to buy antibiotics as OTC medicine in Bangladesh, China, Mozambique, Thailand, and India.
“There are a few recent reports showing that pharmacists dispensed antibiotics without prescriptions or that consumers visit pharmacies to buy antibiotics as OTC medicine, e.g., in Bangladesh [16], China [17], Mozambique [18], Thailand [19], and India [20].”
From Over-the-Counter Sale of Antibiotics in India: A Qualitative Study of Providers’ Perspectives across Two States (2021) · cites this paper as [16]
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“…a tendency to present drug sellers as bad actors bent on evading regulation (Wang et al. 2020), and to prioritize the need to tighten enforcement and improve awareness of ‘rational antimicrobial use’ among individual sellers (Saleem et al., 2019 see also Belachew et al., 2021; Darj et al., 2019).”
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- Authors
- Darj, E., Newaz, M. S., & Zaman, M. H.
- Affiliations
- Uppsala University (SE)
- Norwegian University of Science and Technology (NO)
- Boston University (US)
- Corresponding author
- Darj, Elisabeth
- Venue
- Global Health Action
- Publisher
- Informa UK Limited
- Published
- 2019-12-13
- Volume
- 12
- Issue
- sup1
- Pages
- 1735126-1735126
- ISSN
- 1654-9716 (ISSN-L)
- 1654-9880
- PMC
- PMC7067179
- OpenAlex
- W2974123596
- Cited by
- 28
- References
- 26
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 1 · 2019: 1
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Global Health Action (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- Norwegian University of Science and Technology
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Keywords
- antimicrobial resistance, community pharmacists, pharmacist perceptions, self-medication, antibiotic misuse, community pharmacy, pharmacy regulation, pharmacy education, antimicrobial resistance surveillance, Bangladesh
- MeSH terms
- Antimicrobial Stewardship, Anti-Bacterial Agents, Bangladesh, Humans, Interviews as Topic, Health Knowledge, Attitudes, Practice, Male, Pharmacists, Drug Resistance, Bacterial, Qualitative Research
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