• Shukry Zawahir Faculty of Pharmacy, University of Sydney, NSW, Australia
  • Chathurangani Hettiarachchi Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
  • Hana Morrissey School of Pharmacy, Faculty of Science and Engineering, University of Wolverhampton



Antibiotics, Knowledge, Attitudes, Perception, Sri Lanka, Pharmacy students


Objective: Anti-microbial resistance has become a global problem especially in developing countries. The aim of the study was to evaluate the effect of socio-demographic predictors amongst final year pharmacy undergraduates in Sri Lanka on their knowledge, perception and attitudes regarding antibiotic use.

Methods: A questionnaire-based study involved final year pharmacy students from four public universities in Sri Lanka. Data on knowledge, attitudes and perception about the appropriate use of antibiotics were analysed. Ethics approval was granted by the university of Ruhuna Sri Lanka.

Results: There was good general knowledge of antibiotics (mean=15.57), however, 46% said metronidazole is not an antibiotic, 82% said that the use of antibiotics speed-up the recovery from the common cold. Perception (p=0.033) and attitudes (p=0.028) of respondents from urban area were significantly higher than that of those from rural area.

Conclusion: Clinical education for pharmacy undergraduates should have an in-depth focus on the rational of antibiotics use in Sri Lanka.


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WHO, The global burden of disease, World Health Organization: Geneva; 2004. Available from: healthinfo/global_burden_disease/2004_report_update/en.[Last accessed on 30 Aug 2017]

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. Br Med J 2010;340:c2096.

WHO. Antimicrobial Resistance Global Report on Surveillance. WHO: Geneva; 2014. Available from: drugresistance/documents/surveillancereport/en. [Last accessed on 30 Aug 2017]

Azevedo MM, Pinheiro C, Yaphe J, Baltazar F. Portuguese students' knowledge of antibiotics: a cross-sectional study of secondary school and university students in Braga. BMC Public Health 2009;9:359.

Igbeneghu OA. Knowledge and practices in the use of antibiotics among a group of Nigerian university students. Int J Infect Control 2013;9(i1):8.

Albrich WC, Monnet DL, Harbarth S. Antibiotic selection pressure and resistance in streptococcus pneumoniae and streptococcus pyogenes. Emerging Infect Dis 2004;10:514-7.

van de Sande-Bruinsma N, Grundmann H, Verloo D, Tiemersma E, Monen J, Goossens H, et al. Antimicrobial drug use and resistance in Europe. Emerging Infect Dis 2008;14:1722-30.

Goossens H, Ferech M, Vander Stichele R, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet 2005;365:579-87.

McNulty CA, Nichols T, Boyle PJ, Woodhead M, Davey P. The English antibiotic awareness campaigns: did they change the public's knowledge of and attitudes to antibiotic use? J Antimicrob Chemother 2010;65:1526-33.

Hildreth CJ, Burke AE, Glass RM. Inappropriate use of antibiotics. JAMA 2009;302:816.

Gleckman RA. Selected issues in antibiotic resistance. Infect Med 2004;21:114-22.

WHO. Causes of death summary table. Word health organization: Genva; 2008. Available from: [Last accessed on 30 Aug 2017]

Wang J, Wang P, Wang X, Zheng Y, Xiao Y. Use and prescription of antibiotics in primary health care settings in China. JAMA Internal Med 2014;174:1914-20.

Gulliford MC, Dregan A, Moore MV, Ashworth M, van Staa T, McCann G, et al. Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices. Br Med J 2014;4:e006245.

Lee GC, Reveles KR, Attridge RT, Lawson KA, Mansi IA, Lewis JS, et al. Outpatient antibiotic prescribing in the United States: 2000 to 2010. BMC Med 2014;12:96.

Gaur AH, Hare ME, Shorr RI. Provider and practice characteristics associated with antibiotic use in children with presumed viral respiratory tract infections. Pediatrics 2005;115:635-41.

Erku DA, Surur AS, Gebresillassie BM. Extent of dispensing prescription-only medications without a prescription in community drug retail outlets in Addis Ababa, Ethiopia: a simulated-patient study. Drug Healthcare Patient Safety 2016;8:65-70.

Wafula F. Availability and dispensing practices for antimalarials and antimicrobials in western Kenyan pharmacies. Pharm Reg Affairs 2013;2:8.

Bin Abdulhak AA, Al Tannir MA, Almansor MA, Almohaya MS, Onazi AS, Marei MA, et al. Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: a cross sectional study. BMC Public Health 2011;11:538.

Parimi N, Pinto Pereira LM, Prabhakar P. Caregivers' practices, knowledge and beliefs of antibiotics in paediatric upper respiratory tract infections in Trinidad and Tobago: a cross-sectional study. BMC Fam Pract 2004;5:28.

Srinivasan A, Song X, Richards A, Sinkowitz-Cochran R, Cardo D, Rand C. A survey of knowledge, attitudes, and beliefs of house staff physicians from various specialties concerning antimicrobial use and resistance. Arch Intern Med 2004;164:1451-6.

Lim VK, Cheong YM, Suleiman AB. Pattern of antibiotic usage in hospitals in Malaysia. Singapore Med J 1993;34:525-8.

Wolffers I. Drug information and sale practices in some pharmacies of Colombo, Sri Lanka. Soc Sci Med 1987;25:319-21.

Tomson G, Sterky G. Self-prescribing by way of pharmacies in three Asian developing countries. Lancet 1986;2:620-2.

Wickremasinghe SA, Bibile S. Pharmaceuticals management in Ceylon. Br Med J 1971;3:757-8.

Zawahir S, Lakmali N, Dhakshila N. Pharmacy practice in Sri Lanka, in fathelrahman a (Ed) pharmacy practice in developing countries: achievements and challenges. London, Academic Press; 2016. p. 516.

National Medicines Regulatory Authority (Sri Lanka). 2014. Available from: option=com_ contentandview=articleandid=50andItemid=92andlang=en. [Last accessed on 20 Jul 2014]

Huang Y, Gu J, Zhang M, Ren Z, Yang W, Chen Y, et al. Knowledge, attitude and practice of antibiotics: a questionnaire study among 2500 Chinese students. BMC Medical Education 2013;13:163.

Ahmad A, Khan MU, Patel I, Maharaj S, Pandey S, Dhingra S. Knowledge, attitude and practice of B. Sc. Pharmacy students about antibiotics in Trinidad and Tobago. J Res Pharm Pract 2015;4:37-41

Ganesh M, Sridevi SA, Paul CM. Antibiotic use among medical and para medical students: knowledge, attitude and its practice in a tertiary health care centre. Int J Sci Res 2014;3:4.

Buke C, Hosgor-Limoncu M, Ermertcan S, Ciceklioglu M, Tuncel M, Köse T, et al. Irrational use of antibiotics among university students. J Infect 2005;51:135-9.

Arroll B, Kenealy T. Are antibiotics effective for acute purulent rhinitis? Systematic review and meta-analysis of placebo controlled randomised trials. Br Med J 2006;333:279.

Dallas A, Magin P, Morgan S, Tapley A, Henderson K, Ball J, et al. Antibiotic prescribing for respiratory infections: a cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in primary care. Fam Pract 2015;32:49-55.

Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Systematic Rev 2013;6:CD000247.

Huttner B, Goossens H, Verheij T, Harbarth S. CHAMP Consortium. Characteristics and outcomes of public campaigns aimed at improving the use of antibiotics in outpatients in high-income countries. Lancet Infect Dis 2010;10:17-31.

Dameh M, Norris P, Green PJ. New Zealand pharmacists' experiences, practices and views regarding antibiotic use without prescription. J Prim Health Care 2012;4:131-40.

Radyowijati A, Haak H. Improving antibiotic use in low-income countries: an overview of evidence on determinants. Soc Sci Med 2003;57:733-44.

Awad AI, Aboud EA. Knowledge, attitude and practice towards antibiotic use among the public in kuwait. PLoS One 2015;10:e0117910.

Roque F, Soares S, Breitenfeld L, López-Durán 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.

Chandrakanth P, Mohamed Saleem TS, Reddy MM, Rao MM. Assessment of public knowledge and attitude regarding antibiotic use in a tertiary care hospital. Asian J Pharm Clin Res 2016;118-22. Available from: journals/index.php/ajpcr/article/view/8152 [Last accessed on 30 Aug 2017].



How to Cite

Zawahir, S., C. Hettiarachchi, and H. Morrissey. “ASSESSING KNOWLEDGE, PERCEPTION AND ATTITUDES ABOUT ANTIBIOTICS AMONG FINAL YEAR PHARMACY UNDERGRADUATES IN SRI LANKA”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 9, no. 10, Nov. 2017, pp. 234-9, doi:10.22159/ijpps.2017v9i11.21891.



Original Article(s)