Antimicrobial stewardship: Knowledge, attitudes and practices of healthcare providers in Eastern Uganda

Introduction: Antimicrobial resistance (AMR) is a growing global health threat exacerbated by inappropriate antimicrobial prescribing practices. In low- and middle-income countries (LMICs) like Uganda, additional challenges for effective antimicrobial stewardship include limited resources and healthcare infrastructure. This study assessed current antimicrobial prescribing practices and evaluated healthcare providers' knowledge, attitudes, and practices related to antimicrobial stewardship (AMS) in Eastern Uganda. Methods A cross-sectional study was conducted in healthcare facilities across Eastern Uganda. Data were collected through interviewer administered structured questionnaires. Results 240 respondents completed questionnaires from four health facilities in Eastern Uganda. Respondents were 51.5% male, median age 33 years [IQR 28–38] with 6 years of medical experience [IQR 4–10]. Clinical Officers constituted 22.5%, Medical Doctors 11.2%, Nurses 40.8%, Pharmacists 4.5%, and other categories accounted for 20.8%. Adherence to national and international guidelines on antibiotic use was suboptimal with a high frequency of broad-spectrum antibiotic prescriptions. 75.4% of the respondents reported the presence of an antibiotic resistance control program within their healthcare facility. Most respondents (83.3%) reported a designated leader for AMS at the facility while 86.7% indicated that Pharmacists lead the programmes at facilities. 92.5% of respondents confirmed that there is a policy in place to guide the appropriate dosage and duration of antibiotic treatments. Overall, 98.8% of respondents believed AMR a significant concern and 62.1% indicated that high workloads negatively affect AMS practices. Conclusion The study identifies gaps in antimicrobial prescribing in Eastern Uganda, highlighting the need for improved stewardship programs, training, and policy implementation.