LAUSR

OBJECTIVES To explore the experiences and views of healthcare professionals on antibiotic prescription in Eastern Uganda. METHODS This was an exploratory qualitative study using semi-structured interviews. Participants included 16 healthcare professionals from Mbale and Soroti Regional Referral Hospitals. Additionally, two workshops were held, one in each hospital, with a total of 56 healthcare professionals to discuss the findings. Thematic analysis was used to analyze the data. RESULTS Healthcare professionals' prescriptions are influenced by (1) healthcare workers' perceptions and practices, (2) the patient's perceptions and beliefs, and (3) contextual factors. Healthcare workers' prescriptions depend on the presence of bacterial infections and the severity of the condition, the availability and cost of medication, previous experience with antibiotic prescribing, patient characteristics, and trial and error. They also have limited knowledge and share little information on the usage of antibiotics with patients. Patient factors included the demand for a particular antibiotic, inability to afford expensive drugs, and limited knowledge about antibiotic use and resistance. Contextual factors that contributed to antibiotic prescribing were an overburdened health care system, the influence of pharmaceutical companies and pharmacies, the use of (Treatment) guidelines, and difficulties with laboratory services. CONCLUSIONS This study showed that healthcare professionals are aware of the problem of antibiotic resistance but do not feel ownership of the problem. Instead, they blame rather the overburdened system, the local drug shops, pharmacies, drug representatives, and the patients. There is a need for a multisectoral and holistic approach toward fighting antibiotic resistance.