COMMUNITY PHARMACISTS' KNOWLEDGE, ATTITUDE, PRACTICES AND EFFECTIVENESS OF HEALTHCARE POLICIES TOWARDS DISPENSING OF ANTIBIOTICS WITHOUT PRESCRIPTION (TRNC CASE)

Antibiotic misuse, including self-medication and dispensing without a prescription, threatens the effectiveness of antibiotics, particularly in developing countries. This study assessed community pharmacists’ knowledge, attitudes, and practices regarding dispensing antibiotics without prescription (DAwP), and examined healthcare policies related to the practice in the Turkish Republic of Northern Cyprus (TRNC). A structured, validated 28-item questionnaire in English and Turkish was administered from 1 to 20 April 2019. Stratified sampling covered community pharmacies in eight regions. Of 268 pharmacies, 210 were approached and 162 responded, yielding a 77.14% response rate. In the results, 75.9% of participating pharmacists were unaware that DAwP was illegal in the TRNC. Most recognized its contribution to inappropriate antibiotic use (87.0%), antimicrobial resistance (88.3%), and the public health significance of antimicrobial resistance (91.4%). Although 95.1% reported encouraging patients to consult a doctor before obtaining antibiotics, 84.6% said pharmacists should stop dispensing them without prescriptions. The most commonly reported reasons for DAwP were pharmacists’ confidence in their antibiotic knowledge (66.2%), patients’ reluctance to see a doctor for non-serious infections (62.5%), and the cost of physician consultations (46.3%). Penicillin was the most commonly dispensed antibiotic class without a prescription (90.3%). Years of experience were significantly associated with asking patients about drug allergies (p = 0.04) and kidney problems (p = 0.001); country of graduation was associated with asking about drug allergies (p = 0.004). The findings indicate limited awareness of legal restrictions. Better access to healthcare, academic interventions, and stronger health policies may help reduce DAwP and its public health consequences.