International Journal of Clinical Pharmacy

, Volume 36, Issue 4, pp 787–794 | Cite as

A qualitative study of pharmacists’ perceptions of, and recommendations for improvement of antibiotic use in Qatar

  • Emily BlackEmail author
  • Andrea Cartwright
  • Sumaia Bakharaiba
  • Eman Al-Mekaty
  • Dima Alsahan
Research Article


Background Use of antibiotics has been correlated with increasing rates of resistance. Pharmacists are ideally positioned as front line health care providers to limit indiscriminate antibiotic use and promote the safe and effective administration of these medications. Objective The aim of this project was to assess pharmacists’ opinions relating to antibiotic utilization in the community setting. Setting Doha, Qatar. Method Community and primary care pharmacists were invited to participate in one of three focus groups or a semi-structured interview at Qatar University or at their site of employment. A total of 22 community and primary care pharmacists participated in this study. Interviews were facilitated using a focus group guide, were recorded, and later transcribed. Transcripts were reviewed for recurring themes and coded using Nvivo software for qualitative research. Main outcome measure Pharmacists’ perceptions. Results Five major themes emerged from a series of focus groups and interviews. Themes which recurred across interview groups included: misconceptions and inappropriate practices by patients and healthcare providers, currently implemented strategies, perceived barriers, ways to overcome perceived barriers, and targets for improvement of antibiotic use in Qatar. The greatest need, as identified by pharmacists in this study was increased knowledge of the general population about appropriate antibiotic use through various educational interventions. Conclusion Pharmacists report a number of misconceptions and inappropriate practices relating to antibiotic use in Qatar by patients and healthcare providers. Education to improve knowledge of appropriate antibiotic use is needed. Despite recognition of these issues, barriers are preventing pharmacists from implementing strategies to improve antibiotic use in Qatar.


Antibiotics Community pharmacy General public Pharmacist Pharmacist opinion Qatar 



The authors of this manuscript would like to thank the Qatar Petroleum Health and Wellness Center pharmacy department for their contributions to this project.


This study was completed with funding from an Internal Student Grant from Qatar University.

Conflicts of interest

The authors of this paper report no conflicts of interest.


  1. 1.
    Collignon P, Goldmann D, Goosens H, Gyssens IC, Harbarth S, Jarlier V, et al. Society’s failure to protect a precious resource: antibiotics. Lancet. 2011;378:369–71.PubMedCrossRefGoogle Scholar
  2. 2.
    Baquero F, Beltren JM, Loza E. A review of antibiotic resistance patterns of Streptococcus pneumoniae in Europe. J Antimicrob Chemother. 1991;28:31–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Gould IM. The epidemiology of antibiotic resistance. Int J Antimicrob Agents. 2008;32:S2–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Baquero F. Pneumococcal resistance to beta-lactam antibiotics: a global geographic overview. Microbial Drug Resist. 1995;1(2):115–20.CrossRefGoogle Scholar
  5. 5.
    Song J-H, Jung S-I, Ko KS, Kim NY, Son JS, Chang H–H, et al. High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP Study). Antimicrob Agents Chemother. 2004;48(6):2101–7.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Umgelter A, Reindl W, Miedaner M, Schmid RM, Huber W. Failure of current antibiotic first-line regimens and mortality in hospitalized patients with spontaneous bacterial peritonitis. Infection. 2009;37(1):2–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Antibiotic/Antimicrobial resistance [Internet]. Atlanta, Georgia: Centers for Disease Control and Prevention. 2010 [updated 19 Sept 2012; cited 21 July 2013].
  8. 8.
    Mackenbach JP, Looman CW. Secular trends of infectious disease mortality in The Netherlands, 1911–1978: quantitative estimates of changes coinciding with the introduction of antibiotics. Int J Epidemiol. 1988;17(3):618–24.PubMedCrossRefGoogle Scholar
  9. 9.
    Norrby SR, Nord CE, Finch R, European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Lack of development of new antimicrobial drugs: a potential serious threat to public health. Lancet Infect Dis. 2005;5(2):115–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Antimicrobial resistance [Internet]. World Health Organization. 2013 [updated May 2013; cited 21 July 2013].
  11. 11.
    Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;340. doi: 10.1136/bmj.c2096.
  12. 12.
    Danish Integrated Antimicrobial Resistance Monitoring and Research Programme. Data for action: the Danish approach to surveillance of the use of antimicrobial agents and the occurrence of antimicrobial resistance in bacteria from food animals, food and humans in Denmark. 2nd ed. Denmark: National Food Institute; 2012.Google Scholar
  13. 13.
    Bell BG, Schellivis F, Stobberingh E, Goosens H, Pringle M. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis. 2014;14:13.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Seppala H, Klaukka T, Vuopio-Varkila J, Muotiala A, Helenius H, Lager K. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptocococcus in Finland. N Engl J Med. 1997;337(7):441–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Hicks LA, Chien Y-W, Taylor TH Jr, Haber M, Klugman KP. Outpatient antibiotic prescribing and nonsusceptible streptococcus pneumonia in the United States, 1996–2003. Clin Infect Dis. 2011;53(7):631–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Al-Niemat SI, Bloukh DT, Al-Harasis MD, Al-Fanek AF, Salah RK. Drug use evaluation of antibiotics prescribed in a Jordanian hospital outpatient and emergency clinics using WHO prescribing indicators. Saudi Med J. 2008;29(5):743–8.PubMedGoogle Scholar
  17. 17.
    Kotwani A, Holloway K. Trends in antibiotic use among outpatients in New Delhi, India. BMC Infect Dis. 2011;11:99.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Patton MQ. Qualitative research and evaluation methods. 3rd ed. USA: Sage Publications; 2002.Google Scholar
  20. 20.
    Chan YH, Fan MM, Fok CM, Lok Z, Ni M, Sin CF, et al. Antibiotic nonadherence and knowledge in the community with the world’s leading prevalence of antibiotic resistance: implications for public health interventions. Am J Infect Control. 2012;40(2):113–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Lim KK, Teh CC. A cross sectional study of public knowledge and attitudes towards antibiotics in Putrajaya, Malaysia. South Med Rev. 2012;5(2):26–33.PubMedCentralPubMedGoogle Scholar
  22. 22.
    Shahadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja’fari S. Knowledge, attitudes and behavior regarding antibiotics use in and misuse among adults in the community of Jordan: a pilot study. Saudi Pharm J. 2012;20(2):125–33.CrossRefGoogle Scholar
  23. 23.
    Kadras P, Devine S, Golembesky A, et al. A systematic review and meta-analysis of misuse of antibiotic therapies in the community. Int J Antimicrob Agents. 2006;26:106–13.Google Scholar
  24. 24.
    Corbett KK, Gonzales R, Leeman-Castillo BA, Flores E, Maselli J, Kafadar K. Appropriate antibiotic use: variation in knowledge and awareness by Hispanic ethnicity and language. Prev Med. 2005;40(2):162–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Kotwani A, Wattal C, Joshi PC, Holloway K. Irrational use of antibiotics and role of the pharmacist: insight from a qualitative study in New Delhi, India. J Clin Pharm Ther. 2012;37:308–12.PubMedCrossRefGoogle Scholar
  26. 26.
    World Health Organization consultative group. The role of the pharmacist in the healthcare system. World Health Organization. 1994. Accessed 30 Sept 2013.
  27. 27.
    El-Hajj MS, Salem S, Mansoor H. Public’s attitude towards community pharmacy in Qatar: a pilot study. Patient Prefer Adherence. 2011;5:405–22.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Eades CE, Ferguson JS, O’Carroll RE. Public health in community pharmacy: a systematic review of pharmacist and consumer views. BMC Public Health. 2011;11:582.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Roque F, Soares S, Breitenfeld L, Lopez-Duran A, Figueiras A, Herdeiro MT. Attitudes of community pharmacists to antibiotic dispensing and microbial resistance: a qualitative study in Portugal. Int J Clin Pharm. 2013;35:417–24.PubMedCrossRefGoogle Scholar
  30. 30.
    Coleman CL. Examining influences of pharmacists’ communication with consumers about antibiotics. Health Commun. 2003;15(1):79–99.PubMedCrossRefGoogle Scholar
  31. 31.
    Saramunee, Krska J, Mackridge A, Richards J, Suttajit S, Phillips-Howard P. How to enhance public health service utilization in community pharmacy? General public and health providers’ perspective. Res Social Adm Pharm. 2014;10(2):272–284.Google Scholar
  32. 32.
    Supreme Council of Health. Medical Licensing. Supreme Council of Health. 2014. Accessed 1 March 2014.

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Emily Black
    • 1
    Email author
  • Andrea Cartwright
    • 2
  • Sumaia Bakharaiba
    • 1
  • Eman Al-Mekaty
    • 1
  • Dima Alsahan
    • 1
  1. 1.College of PharmacyQatar UniversityDohaQatar
  2. 2.Pharmacy DepartmentSidra Medical and Research CenterDohaQatar

Personalised recommendations