Comparative Analysis of Antibiotic Dispensing Practices in Public versus Private Pharmacies

Thesis Abstract

The inappropriate dispensing of antibiotics remains a significant contributor to the global rise in antimicrobial resistance, particularly within diverse healthcare delivery frameworks such as public and private pharmacies. This study aims to provide a comprehensive comparative analysis of antibiotic dispensing practices in these two sectors, addressing critical differences that influence antibiotic stewardship and public health outcomes. The specific objectives include evaluating the adherence of pharmacy staff to established dispensing guidelines, identifying instances of antibiotic misuse, and examining the influence of regulatory compliance on dispensing behaviors in both settings. A mixed-methods research design was employed, combining quantitative surveys with qualitative interviews to capture a nuanced understanding of dispensing practices. The target population comprised licensed pharmacists and pharmacy technicians operating within urban regions of the country, with a stratified random sampling technique used to select a total sample size of 300 pharmacists—150 from public pharmacies and 150 from private pharmacies. Data collection instruments included a structured questionnaire designed to assess dispensing adherence and a semi-structured interview guide for an in-depth exploration of underlying behavioral factors. Validity and reliability of the instruments were established via content validation by a panel of experts and pilot testing, achieving Cronbach’s alpha coefficients exceeding 0.8. Quantitative data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression to identify predictors of appropriate dispensing. Thematic analysis was applied to qualitative interview transcripts to contextualize patterns observed in the quantitative data. Additionally, the study tested the applicability of the Theory of Planned Behavior (Ajzen, 1991) and the Health Belief Model (Rosenstock, 1974) as conceptual frameworks for understanding pharmacy staff behaviors related to antibiotic dispensing. It is anticipated that the findings will reveal significant differences between public and private pharmacies regarding adherence to dispensing guidelines, with private pharmacies potentially exhibiting higher rates of antibiotic provision without prescriptions. The analysis is expected to demonstrate that factors such as perceived customer demand, regulatory oversight, and pharmacists’ knowledge significantly influence dispensing practices. Furthermore, the study hypothesizes that regulatory compliance correlates positively with guideline adherence, while perceived economic pressure correlates negatively. This research contributes to the existing body of knowledge by providing empirical evidence on sector-specific dispensing behaviors and identifying key behavioral and systemic determinants. It advances theoretical understanding by validating the role of established behavioral models within the context of pharmacy practice in antimicrobial stewardship. The findings will inform policymakers, healthcare regulators, and pharmacy education programs, suggesting targeted interventions to promote rational antibiotic dispensing. In conclusion, the study underscores the urgent need for strengthened regulatory enforcement and ongoing education to mitigate inappropriate antibiotic distribution in both sectors. Recommendations include the development of standardized guidelines tailored to each sector’s dynamics, implementation of routine compliance audits, and enhanced training programs emphasizing antimicrobial resistance awareness. Future research should explore longitudinal impacts of intervention strategies and expand the scope to rural settings for a more comprehensive national perspective. This study ultimately aims to support sustainable strategies for optimal antibiotic use, thereby contributing to global efforts in combating antimicrobial resistance through improved pharmacy practice.