ORIGINAL ARTICLE Factors influencing dispensing of antibiotics for upper respiratory infections among Southern Thai community pharmacists W. Saengcharoen* MSc, V. Chongsuvivatwong MD PhD, S. Lerkiatbundit à PhD and P. Wongpoowarak* PhD *Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University,  Epidemiology Unit, Faculty of Medicine, Prince of Songkla University and àDepartment of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand SUMMARY Background and objective: Thai community phar- macists are allowed to dispense antibiotics without prescription, and are frequently faced with prob- lems of upper respiratory infections (URI). This study used the theory of planned behaviour to investigate predictors of intention to dispense antibiotics for URI among community pharmacists. Methods: Self-administered questionnaires were mailed to all community pharmacists in the south of Thailand, measuring intention to dispense antibiotics, attitude, subjective norm, perceived behavioural control, behavioural beliefs, norma- tive beliefs and control beliefs. Results and discussion: A total of 656 completed questionnaires were returned out of 833 sent. The pharmacists’ intention to dispense antibiotics for URI was low (mean ± SD; 2Æ35 ± 1Æ85 on a 7-point scale), and strongly influenced by attitude. The beliefs in no benefit of antibiotics had the stron- gest effects on attitude. Subjective norm had a weak effect on intention, whereas perceived behavioural control had practically no effect. Conclusion: Based on this experience of well- informed community pharmacists having proper intention of practice and low control effect, future programme for rational drug use should empha- size education rather than regulation. Keywords: antibiotics, community pharmacist, drugstore, upper respiratory infections INTRODUCTION Respiratory tract infections are among the leading causes of morbidity and mortality in childhood (1). Upper respiratory infections (URI) are the most common illnesses experienced by people of all ages (2). In developing countries, drugstores are one of the critical providers of health care service (3), but they often dispense antibiotics needlessly (4) and uselessly (5). Moreover, this practice may lead to drug reactions (6) and development of drug-resis- tant pathogens (7). In Thailand, drugstores are staffed by either part-time or full-time pharmacists, whose duties include diagnosis of illness and drug-dispensing. A practising pharmacist can legally dispense anti- biotics without prescription. There are a number of reports worldwide of improper antibiotic use for URI (8, 9). Plianbangchang (10) found that the community pharmacists believed antibiotics would be effective in preventing possible infections and reduce the course of disease. Faulty beliefs can be an important factor influencing inappropriate antibiotic dispensing. Past attempts to change provider behaviours based on knowledge provision was not successful (11). A new approach better grounded in theory identifying determinants of this poor practice is required for future inter- ventions. The objectives of this study were to describe the strength of intention of community pharmacists Received 18 October 2006, Accepted 6 November 2007 Correspondence: Woranuch Saengcharoen, MSc, Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand. Tel.: +66 74 428222; fax: +66 74 428222; e-mail: woranuch.s@ psu.ac.th, sworanuch_05@hotmail.com Journal of Clinical Pharmacy and Therapeutics (2008) 33, 123–129 Ó 2008 Blackwell Publishing Ltd 123