Determinants of Utilizing Non-Prescribed Antibiotics among Patients with Bacterial Diseases Visiting Community Pharmacies in Kigali, Rwanda

Abstract: Background: Non-prescribed antibiotic use is a major global public health concern because of its role in driving antimicrobial resistance (AMR), treatment failure, and escalating healthcare costs. This study aimed to determine the prevalence of non-prescribed antibiotic dispensing, assess KAP among community pharmacy staff, and identify associated public health risks in Kigali, Rwanda. Methods: A cross-sectional study was conducted among 207 community pharmacy staff across Gasabo, Nyarugenge, and Kicukiro districts. Data were collected using a structured and validated questionnaire. Descriptive statistics, Chi-square tests, and multivariate logistic regression were applied; statistical significance was set at p < 0.05. Results: A total of 38.6% of respondents reported dispensing antibiotics without a prescription. Azithromycin (23.53%), amoxicillin (19.20%), ciprofloxacin (18.89%), and doxycycline (17.34%) were the most frequently dispensed antibiotics without prescriptions. Knowledge was predominantly moderate (87.0%), attitudes were mostly moderate (72.5%), and practice levels were moderate in 78.7% of participants. Practice level was the strongest and only statistically significant predictor of non-prescribed dispensing: staff with moderate practices were 78.5% less likely (aOR = 0.215; 95% CI: 0.092-0.503; p < 0.001), and those with high practice levels were 96.3% less likely (aOR = 0.037; 95% CI: 0.004-0.330; p = 0.003) to dispense without prescriptions compared to staff with low practice levels. Conclusions: Non-prescribed antibiotic dispensing remains prevalent in Kigali, driven by patient pressure, economic incentives, and regulatory gaps. Practice adherence is the strongest modifiable determinant. Strengthening regulatory enforcement, continuous professional training, and targeted public health education are urgently recommended. Keywords: non-prescribed antibiotics, antibiotic dispensing, community pharmacy, antimicrobial resistance, knowledge, attitudes and practices, Rwanda. Title: Determinants of Utilizing Non-Prescribed Antibiotics among Patients with Bacterial Diseases Visiting Community Pharmacies in Kigali, Rwanda Author: Ishimwe Thierry Patrick, Emile Sebera, Jean Damascene Dusabimana, Emile Twagirumukiza, Donatien Mbonyintwari, Amanuel Kidane Andegiorgish International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 14, Issue 1, April 2026 - September 2026 Page No: 351-359 Research Publish Journals Website: www.researchpublish.com Published Date: 27-June-2026 DOI: https://doi.org/10.5281/zenodo.20958383 Paper Download Link (Source) https://www.researchpublish.com/papers/determinants-of-utilizing-non-prescribed-antibiotics-among-patients-with-bacterial-diseases-visiting-community-pharmacies-in-kigali-rwanda