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Pharmacists' knowledge, attitudes, and practices of dispensing antibiotics without a prescription

Anan S. Jarab1, Walid Al-Qerem2, Karem H. Alzoubi1,3, Shrouq R. Abu Heshmeh1, Ahmad Nor Aldin Alzoubi4, Alaa H. Alsajri5, Shadan W. Al-Hishma6, Yazid Al Hamarneh7, Yousef Mimi8, Rania E. Ghanem9, Maher Khdour9★★ Corresponding author

  1. 1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
  2. 2Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman 11733, Jordan.
  3. 3Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
  4. 4Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
  5. 5School of Pharmaceutical Sciences, University of Sains Malaysia, Peneng, Malaysia.
  6. 6Specialized Bone Marrow Transplant Center, Medical City Complex, Baghdad 61031, Iraq.
  7. 7Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
  8. 8Department of Health Sciences, Faculty of Graduated Studies, Arab American University, Jenin, Palestine.
  9. 9College of Pharmacy, Al-Quds University, Abu Dis, Jerusalem, Palestine.

CORRESPONDENCE

Maher Khdour

College of Pharmacy, Al-Quds University, Abu Dis, Jerusalem, Palestine.

mkhdour@staff.alquds.edu

Received: 17-05-2025; Accepted: 17-07-2025.

Volume 23, Issue 4 · pp. 3250 · PUBLISHED 15 November 2025 · DOI: 10.18549/PharmPract.2025.4.3250

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ABSTRACT

Background: Antibiotics have become some of the most widely used and essential tools in the healthcare system, with the advantage of saving millions of lives. However, the overuse and misuse of antibiotics led to the emergence of resistant microorganisms. Objective: To assess community pharmacists' knowledge, attitude, and practice in relation to dispensing antibiotics without prescription. Methods: In this cross-sectional study, a validated survey was distributed in person as Google Forms to community pharmacists across different regions in Jordan using convenience sampling. A quantile regression was conducted to explore the factors associated with attitude and practice of antibiotics dispensing without prescription. Results: Pharmacists (N=351) exhibited moderate knowledge regarding antibiotic use and resistance, with a median score of 4 (range 3-5) out of a possible 7 points. The median attitude score was 22 (20-24), out of maximum possible score of 25, indicating favourable attitudes towards antibiotics prescription. Regression analysis demonstrated that higher knowledge scores were associated with higher attitude scores (coefficient = 0.106, 95%CI: 0.007 - 0.206, p = 0.036). Additionally, higher attitude scores were linked to a reduced likelihood of dispensing antibiotics without a prescription (coefficient = -0.302, 95%CI: 0.588 - 0.929, p = 0.010). Conclusion: The study indicated moderate knowledge of antibiotics among pharmacists and a generally favourable attitude toward their prescription. Greater knowledge was associated with a more positive attitude, which was linked to a lower likelihood of dispensing antibiotics without a prescription. Future initiatives should aim to enhance pharmacists' understanding of antibiotic use and resistance, as well as implement stricter dispensing regulations to reduce the use of antibiotics without prescriptions and address antimicrobial resistance.

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    Jarab, A. S., Al-Qerem, W., Alzoubi, K. H., Heshmeh, S. R. A., Alzoubi, A. N. A., Alsajri, A. H., Al-Hishma, S. W., Hamarneh, Y. A., Mimi, Y., Ghanem, R. E., & Khdour, M. (2025). Pharmacists' knowledge, attitudes, and practices of dispensing antibiotics without a prescription. Pharmacy Practice, 23(4), 3250. https://doi.org/10.18549/PharmPract.2025.4.3250