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Exploring factors that influence the supply and use of antibiotics from community pharmacies in Thailand

Donsamak, Sisira 2020. Exploring factors that influence the supply and use of antibiotics from community pharmacies in Thailand. PhD Thesis, Cardiff University.
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In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported, and is associated with increased antimicrobial resistance. This study aims to explore factors influencing the use and supply of antibiotics from community pharmacies in Thailand. Semi-structured interviews with Thai community pharmacists (n=23) and citizens (n=21) were conducted to explore the practice and reasons for antibiotic supply from pharmacies. Findings from the interviews and a literature review were used to develop a questionnaire for a stratified sample of community pharmacists, including nine vignettes for pharmacists to identify how they would respond in practice. Approval was obtained from Thailand and Wales ethics committees. Three-hundred-and-twenty community pharmacists in all four Thai regions responded. In response to vignettes, 46% (147/320) of pharmacists would supply antibiotics without an appropriate indication for a URI, 50% (321/638) of pharmacists would suggest inappropriate antibiotics and/or regimens for patients with possible/probable group A streptococcal pharyngitis. In addition, 13% (74/640) and 11% (71/638) of pharmacists would supply antibiotics for acute diarrhea and simple wounds, respectively, where antibiotics were not recommended. Inappropriate antibiotic choices and/or incorrect dosage regimens were also reported. A higher proportion of younger pharmacists and/or those with less experience, Pharm D. graduated pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to indicate appropriate antibiotic supply in response to the vignettes (p<0.05). Additionally, pharmacists who perceived an advantage of antibiotics is being cured quickly, were more likely to indicate less appropriate supply of antibiotics (p<0.05). The findings suggest that improved public education, more pharmacist education on antibiotic use and AMR, better enforcement of existing regulations and stricter regulation on the supply of some antibiotics may lead to improved rational antibiotic use in Thailand.

Item Type: Thesis (PhD)
Date Type: Completion
Status: Unpublished
Schools: Pharmacy
Subjects: Q Science > Q Science (General)
Date of First Compliant Deposit: 17 December 2020
Last Modified: 26 Oct 2021 01:35

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