Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study

Antibiotic resistance is a worldwide public-health challenge that has threatened the health and socio-economic sector of all countries irrespective of their level of income and development. Low- and middle-income countries (LMICs) are more severely affected owing to overstretched health systems and poor access to alternative antibiotic regimens [1], [2]. Although resistance is a natural phenomenon, many anthropogenic factors drive the emergence and spread of resistant pathogens. Among these is the unnecessary and inappropriate prescription of antibiotics [3]. Antibiotic misuse is a particular problem in primary care. Approximately 90% of all antibiotic prescriptions are issued by general practitioners, and respiratory tract infections are the leading reason for antibiotic prescribing [4].

Healthcare professionals prescribe antibiotics for either prophylactic or therapeutic reasons. But the decision of when and what to prescribe leaves room for unnecessary use of antibiotics that often drives resistance [5], [6], [7]. Prescription practices are influenced by several factors such as level of education, years of experience, availability of drugs and laboratories, availability of treatment guidelines, patient load and motivation, among others [8], [9]. However, there is a paucity of evidence in LMIC settings regarding the experiences and practices of healthcare professionals who prescribe and dispense antimicrobial agents [10].