Pharmacy professionals' knowledge, attitudes, and behaviours regarding antibiotic use and antimicrobial resistance in Oman.

Abstract

Background: This study evaluated pharmacy professionals' knowledge, attitudes, and behaviours regarding antibiotic use and antimicrobial resistance (AMR) in Oman.

Methods: A cross-sectional, questionnaire-based survey was conducted among 411 pharmacy professionals in Ministry of Health (MOH) institutions from January to June 2023. This questionnaire is based on instruments developed by the European Centre for Disease Prevention and Control and assesses knowledge, opportunities, behaviours, and awareness of national initiatives.

Results: A total of 411 pharmacy professionals participated in the study. Overall, participants demonstrated knowledge of AMR, with an understanding of antibiotic effectiveness against viruses (89.3%) and inappropriate use (96.4%), but important gaps in knowledge of resistance transmission (44.8%) and antibiotic use for growth promotion in farm animals (31.4%). Higher median knowledge scores were observed among senior specialist pharmacists ( $p<0.001$ ), while respondents aged 36-45 years and those with 16-20 years of practice achieved the highest proportions of full knowledge scores ( $p<0.001$ ). Although 91% of respondents reported confidence in their understanding of AMR, specific knowledge gaps were identified: 56.2% were unsure whether antibiotic use for growth promotion in farm animals was legal in Oman, and 36% were unaware of or unsure about Oman's National Action Plan. Most respondents reported having opportunities to provide patient counselling (82%) and access to guidelines (63%), while 59.9% reported frequent antibiotic dispensing in practice. Importantly, among the 217 respondents who reported that the information changed their views, 208 (95.9%) participants indicated that this knowledge influenced their dispensing practices.

Conclusions: Pharmacy professionals in Oman demonstrated awareness and positive perceptions regarding antibiotic use and antimicrobial resistance, although gaps remained in awareness and understanding of One Health principles, national initiatives, and the translation of knowledge into dispensing practice. Strengthening targeted education, guideline access, and pharmacist involvement in antimicrobial stewardship may improve appropriate antibiotic use and support AMR control.