Antimicrobial resistance (AMR) is a growing public health issue. Understanding patients’ and health care professionals’ motives for antibiotic (AB) use is important to battle AMR. Studies investigating AB-related knowledge, attitudes and behaviors are sparse in the Middle East countries.

This study aimed to explore knowledge, attitudes and practices of AB dispensing and use for upper respiratory tract infections (URTI) among pharmacy personnel and patients in Bagdad, Iraq.

A qualitative interview study was conducted. Pharmacy personnel in community pharmacies and patients, who were, respectively, dispensing and pursuing ABs for URTI, were recruited from community pharmacies situated in three different districts of Bagdad. Interview guides were inspired by a similar study in North Western Russia. Interviews were transcribed verbatim and analyzed using inductive content analysis.
In total, 16 patients (44% females, age 25-51 years, 56% pursuing AB without prescriptions), and 14 community pharmacy personnel (71% pharmacists, 64% female, age 23-32 years) were interviewed. Pharmacy personnel interviews revealed two themes as reasons to dispense an AB without prescription: 1) self-perception of pharmacists as confident and empathic healthcare professionals; 2) non-medical circumstances supporting increased ABs’ sales (e.g. economic considerations or practice habits). Patient interviews revealed similar two themes: 1) trust in pharmacists as healthcare professionals; 2) practical reasons for not acquiring an AB prescription (e.g. lack of time and money).
The study showed that the dispensing and use of ABs in Bagdad does not always follow the rules and guidelines. To strengthen appropriate use of ABs, non-medical circumstances around ABs prescribing should be considered.