Antimicrobial stewardship in private pharmacies in Wakiso district, Uganda: a qualitative study

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Musoke, D, Lubega, GB, Gbadesire, MS, Boateng, S, Twesigye, B, Gheer, J, Nakachwa, B, Brown Obeng, M ORCID: https://orcid.org/0000-0002-9248-8693, Brandish, C, Winter, J ORCID: https://orcid.org/0000-0003-3582-7596, Ng, BY, Russell-Hobbs, K and Gibson, L ORCID: https://orcid.org/0000-0002-1220-8680, 2023. Antimicrobial stewardship in private pharmacies in Wakiso district, Uganda: a qualitative study. Journal of Pharmaceutical Policy and Practice, 16: 147. ISSN 2052-3211

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Official URL: https://doi.org/10.1186/s40545-023-00659-5

Abstract

Background: Private pharmacies are the first point of contact for the public regarding acquisition of medicines and other pharmaceuticals in many low- and middle-income countries including Uganda. Most antimicrobial stewardship (AMS) programmes in Uganda have targeted pharmacies in public health facilities, with little known about private pharmacies. This study explored knowledge and practices related to AMS in private pharmacies in Wakiso district, central Uganda.

Methods: This was a qualitative study that involved 31 in-depth interviews to explore AMS among retail private pharmacy staff including pharmacists, pharmacy technicians/dispensers, and nurses. Participants were asked about antimicrobial resistance (AMR) and AMS practices at their pharmacy. The audio-recorded interviews were transcribed verbatim and imported to NVivo 2020 (QSR International) for thematic analysis.

Results: Five major themes emerged from the study: commonly sold antimicrobials; knowledge on AMR and AMS; potential contributors to AMR; practices related to AMS; and challenges to AMS. The commonly sold antimicrobials in the pharmacies with or without prescriptions were oral azithromycin, Ampiclox® (ampicillin and cloxacillin), amoxicillin, ciprofloxacin, Septrin® (co-trimoxazole), metronidazole, Flucamox® (amoxicillin and flucloxacillin), Augmentin® (amoxicillin and clavulanic acid), cephalexin, doxycycline, and chloramphenicol. Participants had heard about AMR but not AMS, although only a few correctly defined AMR. Lack of knowledge among health workers and local communities; the overuse, misuse, and abuse of antimicrobials such as non-adherence to dosage; self-medication; and purchase of drugs without prescription were identified as potential accelerators to the emergence of AMR. Current practices related to AMS in private pharmacies were limited to meetings, antimicrobial dispensing, providing client advice, record keeping, and monitoring of drugs. Cost of healthcare, client satisfaction and retention, outdated guidelines, and the business orientation of pharmacies were the main challenges related to AMS.

Conclusion: There was poor knowledge of AMR and AMS, and limited AMS practices in private pharmacies. Private pharmacies have the potential to contribute to Uganda’s fight against AMR if motivated and equipped with adequate knowledge to enhance their practices related to AMS.

Item Type:	Journal article
Publication Title:	Journal of Pharmaceutical Policy and Practice
Creators:	Musoke, D., Lubega, G.B., Gbadesire, M.S., Boateng, S., Twesigye, B., Gheer, J., Nakachwa, B., Brown Obeng, M., Brandish, C., Winter, J., Ng, B.Y., Russell-Hobbs, K. and Gibson, L.
Publisher:	Informa UK Limited
Date:	17 November 2023
Volume:	16
ISSN:	2052-3211
Identifiers:	Number Type 10.1186/s40545-023-00659-5 DOI 1851128 Other
Rights:	© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Divisions:	Schools > School of Science and Technology Schools > School of Social Sciences
Record created by:	Jeremy Silvester
Date Added:	12 Jan 2024 11:04
Last Modified:	12 Jan 2024 11:04
URI:	https://irep.ntu.ac.uk/id/eprint/50676