Exploring knowledge, perceptions, and practices of antimicrobials, and their resistance among medicine dispensers and community members in Kavrepalanchok District of Nepal

• Published in: PloS one Vol. 19; no. 1; p. e0297282
• Main Authors: Marasini, Sabina, Sharma, Sudim, Joshi, Anjali, Kunwar, Surakshya, Mahato, Roshan Kumar, Shrestha, Archana, Karmacharya, Biraj
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19-01-2024; Public Library of Science (PLoS)
• Subjects: Analysis; Anti-Bacterial Agents - therapeutic use; Anti-Infective Agents - pharmacology; Anti-Infective Agents - therapeutic use; Antimicrobial agents; Antimicrobial resistance; Codes; Community; Confidentiality; Consent; Consumers; Data collection; Developing countries; Dispensers; Dispensing; Distribution; Drug resistance; Drug resistance in microorganisms; Drug stores; Drugs; Drugstores; Ethics; Focus Groups; Health aspects; Humans; Interviews; LDCs; Management; Medical treatment; Medicine; Nepal; Nonprescription drugs; Nonprescription Drugs - therapeutic use; Participation; Pharmacists; Pharmacy; Policies; Prevention; Public health; Qualitative analysis; Self Medication; Nepal
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0297282

Inappropriate use of antimicrobials is a global public health issue, particularly in developing countries, including Nepal, where over-the-counter sales and self-medication of antimicrobials are common.
To explore knowledge, perceptions, and practices of antimicrobials and their resistance among medicine dispensers and community members in Nepal.
The study was conducted in three rural and five urban municipalities of the Kavrepalanchok district from May 2021 to August 2021. Data were collected using two qualitative approaches: In-Depth Interviews (IDIs) and Focus Group Discussions (FGDs). Data were analyzed using thematic analysis that combined deductive and inductive approaches to identify codes under pre-specified themes.
A total of 16 In-depth interviews with medicine dispensers and 3 focus group discussions with community members were conducted. Knowledge regarding antimicrobial resistance varied among dispensers. Those with a prior educational background in pharmacy often had good knowledge about the causes and consequences of antimicrobial resistance. Meanwhile, consumers were less aware of antimicrobial resistance. Community members perceived antimicrobials as effective medicines but not long-term solution for treating diseases. They reported that dispensing without a prescription was common and that both consumers and dispensers were responsible for the inappropriate use of antimicrobials. On the contrary, several dispensers said that self-medication was common among the consumers, especially among more educated groups. The medicine dispensers and consumers expressed concerns about the weak enforcement of policies regarding pharmacy drug use and dispensing practices.
Promoting and strengthening the appropriate use of antimicrobials among medicine dispensers and community members is crucial. Bold policies and collective implementation of regulations could help combat antimicrobial resistance.