Knowledge, attitudes and practices surveyon antimicrobial resistance and stewardship among pharmacy healthcare workers in 28 African countries

This large survey across 28 African countries assessed the knowledge, attitudes, and practices (KAP) of 908 pharmacy healthcare workers involved in antibiotic dispensing. While most respondents showed good knowledge (71.3%) and attitudes (59.9%) toward antimicrobial resistance (AMR) and stewardship (AMS), fewer (41.6%) demonstrated good dispensing practices. Key influences on inappropriate antibiotic dispensing included patient demand and pharmaceutical company pressure. Licensed pharmacists were significantly more knowledgeable than technicians, women showed more positive attitudes than men, and those in public facilities practiced better stewardship than those in private ones. Overall, strong AMR knowledge was linked to better attitudes and practices. The study highlights the urgent need for targeted education and training to strengthen responsible antibiotic use in African healthcare settings.