ArticleInfection and drug resistance2019
What drives inappropriate use of antibiotics? A mixed methods study from Bahawalpur, Pakistan.
Article in Infection and drug resistance, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
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Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Drivers of inappropriate use of antibiotics among community members in low- and middle-income countries: a systematic review of qualitative studies.BMC public health · 2025Pooled it
- Improving antibiotic use through behaviour change: a systematic review of interventions evaluated in low- and middle-income countries.Health policy and planning · 2021Pooled it
- Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data.BMC global and public health · 2026Article
- Article
- Perspectives and Challenges of Healthcare Professionals, Patients, and Caregivers Regarding Utilizing Antibiotics and Implementing Antibiotic Stewardship in Healthcare Facilities in Low- and Middle-Income Countries: A Systematic Review of Qualitative Studies.Antibiotics (Basel, Switzerland) · 2026Review
- Knowledge, Attitudes and Dispensing Practices Regarding Antimicrobial Resistance and Stewardship:Sultan Qaboos University medical journal · 2026Article
- Antibiotic Use by Paediatric Residents of the Oman Medical Specialty Board:Sultan Qaboos University medical journal · 2025Article
- Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Antibiotic self-medication in Otuke District, Northern Uganda: Prevalence and associated factors.PloS one · 2025Article
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
- Understanding the Determinants Influencing Self-Medication with Antibiotics Among Malaysian Residents: A Qualitative Study to Inform Preventive Public Health Strategies.Antibiotics (Basel, Switzerland) · 2024Article
- Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence.JAC-antimicrobial resistance · 2024Review
- Prevalence of self-medication practices with antibiotics and associated factors among students in five colleges in Eritrea: a cross-sectional study.Antimicrobial resistance and infection control · 2024Article
- Cross-sectional survey to explore knowledge, attitude, practices and impact of an intervention programme related to antibiotic misuse and self-medication among general population of Pakistan.BMJ public health · 2024Article
- Drivers of inappropriate use of antimicrobials in South Asia: A systematic review of qualitative literature.PLOS global public health · 2024Article
- Article
- Antibiotic use among hospitalised patients in Sierra Leone: a national point prevalence survey using the WHO survey methodology.BMJ open · 2023Article
- Evaluation of the Antibacterial Activities of Mangrove Honeybee Propolis Extract and the Identification of Transpeptidase and Transglycosylase as Targets for New Antibiotics Using Molecular Docking.Antibiotics (Basel, Switzerland) · 2023Article
- A Cross-Sectional Study of Potential Antimicrobial Resistance and Ecology in Gastrointestinal and Oral Microbial Communities of Young Normoweight Pakistani Individuals.Microorganisms · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study investigates the knowledge, attitudes and practices of the general public regarding the use of antibiotics in community pharmacy, in Pakistan.
methodsThis is a mixed method study where data were collected through a validated questionnaire and semi-structured interviews. Convenience sampling techniques were used to recruit participants from the general public of Bahawalpur, Pakistan who visited pharmacies to purchase antibiotics between 1 June 2018 and 31 July 2018. Descriptive statistics and regression analyses were used to tabulate the results of quantitative data while inductive thematic analysis was used to identify themes and draw conclusions from the qualitative data.
resultsOver 60% of the 400 survey participants (n=246; 61.5%) had a moderate level of antibiotic knowledge; however, attitudes regarding antibiotics use were poor in half the sample (n=201; 50.3%). More than half (n=226; 56.6%) of the respondents stated that antibiotics could cure all types of infections. Just under one third (n=129; 32.3%) of respondents obtained the appropriate dosage regimen while the majority did not complete the course (n=369; 92.3%); stopping when they felt better. Inductive thematic analysis yielded four themes, 10 subthemes and 27 categories. Two subthemes were related to knowledge, one to attitude, three to practices and four subthemes were related to suggestions to improve the healthcare system. Inappropriate antibiotic practices included: lack of consultation with healthcare professionals, purchase of antibiotics without prescription or refilling of previous prescription, use of home supply of antibiotics, sharing of antibiotics with others, improper dosage regimens and early cessation of antibiotic therapy.
conclusionLevel of education, low health literacy, high consultation fees of private practitioners, inadequate health facilities in government hospitals and patient overload, busy schedules of people, poor healthcare infrastructure in rural areas and unrestricted supply of antibiotics were key factors associated with inappropriate use of antibiotics in Pakistan.
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