Publication: COMMUNITY PHARMACISTS AND ANTIMICROBIAL STEWARDSHIP IN MALAYSIA: EVALUATING PRACTICES, IMPLEMENTATION BARRIERS AND FACILITATORS, AND PERCEPTIONS
Date
2025
Authors
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Journal ISSN
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Publisher
IMU University
Abstract
BACKGROUND
Antimicrobial resistance (AMR) is a critical global health challenge, necessitating widespread antimicrobial stewardship (AMS) across all healthcare sectors, including community pharmacies. Community pharmacists (CPs) play a key role in AMS by ensuring responsible antimicrobial dispensing, educating patients, and collaborating with prescribers. However, barriers such as limited training, unclear professional roles, and regulatory challenges hinder AMS implementation. This study aims to assess the extent of AMS application among CPs in Malaysia, identify key facilitators and barriers to AMS implementation, and evaluate the perception of AMS among CPs nationwide. Ultimately, our research can help to design a suitable AMS programme for CPs in Malaysia.
METHODS
A nationwide cross-sectional survey was conducted among 401 registered CPs across Malaysia, selected through convenience sampling. A structured, self-administered questionnaire assessed perceived AMS awareness, antimicrobial dispensing practices, and implementation barriers. The survey was distributed via a Google survey link and disseminated through Whatsapp. Data were analysed and statistical analyses were performed using SPSS (version 28). Descriptive statistics summarised responses, while the Mann–Whitney U and Kruskal–Wallis tests examined associations between demographic factors and AMS-related attitudes, practices, and barriers. Dunn’s post hoc test with Bonferroni correction was pplied for multiple comparisons (p = 0.050).
RESULTS
Among 401 respondents, 89.0% adhered to prescription regulations, 66.8% consulted national guidelines, and 97.3% educated patients on unnecessary antibiotic use. Collaboration with prescribers was common, with 97.0% encouraging physician consultations. CPs emphasised patient education, with 93.0% raising AMR awareness and 97.8% reinforcing full-course completion. Facilitators included ethical commitment, with 81.0% ensuring valid prescriptions and 89.0% prioritising patient safety over revenue. Barriers included AMS training gaps (28.7%), unclear AMS roles (31.2%), and logistical constraints (29.4%). CPs with 3–10 years of experience were more proactive in AMS, while hospital-trained CPs had greater perceived AMS awareness.
CONCLUSION
This study underscores the crucial role of CPs in AMS, with strong adherence to AMS principles. However, gaps in training, role clarity, and structured protocols remain. Addressing these barriers through targeted training, clear guidelines, and CP-GP collaboration will enhance AMS application, empowering CPs to combat AMR effectively in community settings.
Keywords
AMR; Antimicrobial Resistance; AMS; Antimicrobial Stewardship; Community Pharmacists
Description
Keywords
Pharmacists, Antimicrobial Stewardship, Malaysia, Cross-Sectional Studies, Perception