KNOWLEDGE, ATTITUDES, AND PRACTICES (KAP) OF COMMUNITY PHARMACISTS IN KARACHI REGARDING ANTIMICROBIAL STEWARDSHIP (AMS) AND ITS ASSOCIATION WITH THEIR PERCEIVED COMPETENCE IN PATIENT COUNSELING

Background: Antimicrobial resistance poses a severe threat to global public health, with community pharmacists serving as crucial frontline defenders. While their knowledge and practices are often studied, the psychological drivers of their effectiveness, particularly their perceived competence in stewardship counseling, remain poorly understood. Objective: This study aimed to assess the knowledge, attitudes, and practices (KAP) of community pharmacists in Karachi regarding antimicrobial stewardship (AMS) and to identify the key predictors of their perceived competence in patient counseling. Methods: A cross-sectional study was conducted with 165 community pharmacists using a validated, self-administered questionnaire. Data were analyzed using descriptive statistics and multiple linear regression to determine the associations between KAP scores and perceived competence. Results: The analysis revealed that while knowledge and practices showed positive associations, only attitudes emerged as a statistically significant predictor of perceived competence (β = 0.289, p = 0.044). This indicates that a pharmacist's confidence is more strongly influenced by their underlying beliefs and professional mindset than by their knowledge base alone. Conclusion: The findings suggest that to fully leverage community pharmacists in the fight against antimicrobial resistance, interventions must move beyond traditional education. Training programs should be redesigned to actively cultivate positive attitudes, strong professional identity, and communication resilience, thereby empowering pharmacists with the confidence needed to be effective stewards.