OBJECTIVES: Injudicious use of antibiotics is one of the hallmarks in the emergence of antimicrobial resistance (AMR). Pharmacists have crucial roles as gatekeepers against the non-prescription use of antimicrobials and as patient educators. The aim of our study was to evaluate the knowledge and attitude of pharmacists on infectious diseases and AMR in Hungary.

METHODS: A self-administered, 68-item questionnaire was developed by an expert panel, including questions on knowledge-level (40 questions from four different subject areas) and attitudes (18 items). Convenience and snowball sampling methods were adopted, data collection was carried out between January 2019-January 2020. Descriptive statistics and nonparametric tests were performed by IBM SPSS Statistics 22.0.

RESULTS: During pilot studies, Cronbach’s α and Kuder-Richardson K20 values were all in the acceptable range. Based on exploratory factor analysis, two main attitude domains were identified. The 340 respondents were polled 65.0% female, the median age was 29 years (range: 23-74), 74.7% worked in community pharmacies. 50.7% had ≥5 years of work experience, while 54.4% had at least one specialty (or were in training). The mean of correct answers was 20.06±6.63 overall (medical microbiology: 6.32±2.00, clinical pharmacy/pharmaceutical care: 4.94±2.25, infection prevention/control: 4.73±2.40, pharmacology: 4.04±2.33); 52.1% had reached a ≤50% score. Females (21.15±6.29 vs. males: 18.05±6.79; p<0.001), pharmacists with specialties (20.88±6.62 vs. without specialties: 19.09±6.53; p<0.001) and respondents who perceived their past academic achievements as adequate (21.20±6.53 vs. dissatisfied respondents: 17.42±6.14; p=0.013) had higher overall knowledge. 64.1% and 62.9% showed appropriate attitude scores on external (score≥7) and internal responsibility (score≥6) towards AMR. Pharmacists with appropriate attitudes showed higher knowledge scores (21.06±6.18 vs. inadequate attitude: 18.29±7.05; p<0.001).

CONCLUSIONS: We have demonstrated that our questionnaire was an effective tool for identifying critical knowledge gaps and undesirable attitudes of pharmacists regarding AMR; our results may aid the design of effective and targeted educational interventions.