ArticleBMJ open2020
Qualitative study of antibiotic prescription patterns and associated drivers in Sudan, Guinea-Bissau, Central African Republic and Democratic Republic of Congo.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- The Applicability of AWaRe-Based Antibiotic Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa: A Multicentre Point Prevalence Study and Implications for the Future.Antibiotics (Basel, Switzerland) · 2026Article
- Perspectives and Challenges of Healthcare Professionals, Patients, and Caregivers Regarding Utilizing Antibiotics and Implementing Antibiotic Stewardship in Healthcare Facilities in Low- and Middle-Income Countries: A Systematic Review of Qualitative Studies.Antibiotics (Basel, Switzerland) · 2026Review
- Insights into antimicrobial resistance awareness among Sri Lankan medical practitioners: a qualitative study.BMJ open · 2025Article
- Antimicrobial resistance of Enterobacterales in Central Africa: a systematic review and meta-analysis.Communications medicine · 2025Article
- Healthcare workers´ perspectives on antibiotic utilization in children under five years of age in the Eastern Democratic Republic of the Congo.Antimicrobial resistance and infection control · 2025Article
- Knowledge, Attitudes, and Practices of Iraqi Parents Regarding Antibiotic Use in Children and the Implications.Antibiotics (Basel, Switzerland) · 2025Article
- Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence.JAC-antimicrobial resistance · 2024Review
- Exploring factors for antibiotic over-prescription in children with acute upper respiratory tract infections in Assiut, Egypt: a qualitative study.Antimicrobial resistance and infection control · 2024Article
- Impact of digital clinical decision support on quality of care and antibiotic stewardship for children under five in South-Central Somalia.Oxford open digital health · 2024Article
- Association between culture and the preference for, and perceptions of, 11 routes of medicine administration: A survey in 21 countries and regions.Exploratory research in clinical and social pharmacy · 2023Article
- Influences on treatment-seeking and antibiotic use for common illnesses in eastern China.BMC public health · 2023Article
- Antimicrobial stewardship in primary health care programs in humanitarian settings: the time to act is now.Antimicrobial resistance and infection control · 2023Article
- Practices and challenges related to antibiotic use in paediatric treatment in hospitals and health centres in Niger and Uganda: a mixed methods study.Antimicrobial resistance and infection control · 2023Article
- Overuse of medications in low- and middle-income countries: a scoping review.Bulletin of the World Health Organization · 2023Article
- Determinants of clinician and patient to prescription of antimicrobials: Case of Mulanje, Southern Malawi.PLOS global public health · 2022Article
- Access, use and disposal of antimicrobials among humans and animals in Wakiso district, Uganda: a qualitative study.Journal of pharmaceutical policy and practice · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
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Abstract
objectivesThe objective of this study was to address the knowledge gap regarding antibiotic use in Medecins Sans Frontiéres (MSF) projects located in Africa by exploring antibiotic prescription and consumption habits and their drivers at different healthcare levels.
designThis study used an exploratory study design through thematic analysis of semistructured, in-depth interviews, focus group discussions (FGDs) and field observations in order to understand the main drivers influencing current antibiotics prescription habits and consumption habits of patients in different geographical settings.
settingThe study took place in MSF centres and towns across four countries: Guinea-Bissau, Central African Republic (CAR), Democratic Republic of Congo (DRC) and Sudan.
participants384 respondents participated in the study, which includes project staff, prescribers, community members, patients, among other groups.
resultsTreatment protocols were physically present in all countries except DRC, but compliance to protocols varied across contexts. A failing health system and barriers to accessing healthcare were perceived as major drivers of overuse and inconsistent prescription practices. Patient demands influenced prescription decisions, and self-medication was commonly reported in the context of failing health systems. Additionally, there was a strong demand for quick cures and communities preferred injections over pills. Patients tended to stop antibiotic treatment once symptoms abated and had major gaps in understanding antibiotic intake instructions and functions.
conclusionsWhile there were specific findings in each context, the larger trend from these four MSF projects in Africa indicates widespread use of antibiotics based on unclear assumptions, which are often influenced by patient demands. There needs to be a broader focus on the balance between access and excess, especially in such fragile contexts where access to healthcare is a real challenge.
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