Evidence map›Paper›PMID 41306698›Full record

ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2025

Physician knowledge, attitudes, and perceptions of antibiograms: a pre-implementation study in southern Sri Lanka.

Lorenna C Garcia-Bochas, Sherine Nanayakkara, Perla Medrano, Ajith Nagahawatte, C Lakmal Fonseka, Armstrong Obale, Bhagya Piyasiri, Ruvini Kurukulasooriya, Madureka Premamali, Ganga Moorthy and 6 more

Abstract read
In one paragraph

Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Lorenna C Garcia-BochasDuke University, Durham, NC, USA.ORCID https://orcid.org/0000-0001-8905-9786
Sherine NanayakkaraDuke-Ruhuna Collaborative Research Centre, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Perla MedranoDuke University, Durham, NC, USA.ORCID https://orcid.org/0000-0001-5292-5265
Ajith NagahawatteDuke Global Health Institute, Durham, NC, USA.
C Lakmal FonsekaDuke-Ruhuna Collaborative Research Centre, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.ORCID https://orcid.org/0000-0003-3364-6257
Armstrong ObaleDuke Global Health Institute, Durham, NC, USA.ORCID https://orcid.org/0009-0006-5804-5377
Bhagya PiyasiriNational Hospital Galle, Galle, Sri Lanka.ORCID https://orcid.org/0000-0002-4660-311X
Ruvini KurukulasooriyaDuke-Ruhuna Collaborative Research Centre, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Madureka PremamaliDuke-Ruhuna Collaborative Research Centre, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Ganga MoorthyDuke University, Durham, NC, USA.ORCID https://orcid.org/0000-0003-3191-1117
Lana AbusalemDuke Global Health Institute, Durham, NC, USA.ORCID https://orcid.org/0000-0003-1591-9725
Melissa H WattUniversity of Utah, School of Medicine, Department of Population Health Sciences, Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0003-1317-3536
Christopher W WoodsDuke University, Durham, NC, USA.
Truls ØstbyeDuke University, Durham, NC, USA.ORCID https://orcid.org/0000-0002-0662-7440
Champica BodinayakeDuke Global Health Institute, Durham, NC, USA.ORCID https://orcid.org/0000-0003-1339-1883
L Gayani TillekeratneDuke University, Durham, NC, USA.ORCID https://orcid.org/0000-0001-6012-7271

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: The purpose of this study is to explore physicians' knowledge, attitudes, and perceptions toward antibiograms and identify perceived barriers and facilitators to their implementation in a low-resource setting in Sri Lanka. Design: A qualitative study utilizing semi-structured interviews and thematic analysis. Setting: A public tertiary care hospital in southern Sri Lanka. Participants: Thirty physicians working in pediatric and adult medical wards were purposively sampled and interviewed between June and August 2023. Results: Most physicians had limited prior knowledge or experience with antibiograms. However, after receiving a brief explanation, 29 out of 30 participants expressed strong support for implementing antibiograms, citing potential benefits such as improved antibiotic prescribing, reduced antimicrobial resistance (AMR), and enhanced patient outcomes. Approximately one-third of participants expressed concerns about feasibility due to time constraints, limited laboratory infrastructure, and personnel shortages. Participants recommended delivering antibiogram training through small-group sessions led by a multidisciplinary team. Thematic analysis identified three core themes: (1) limited baseline knowledge of antibiograms, (2) perceived clinical value and enthusiasm for implementation, and (3) barriers related to healthcare system constraints. Conclusions: Physicians in this LMIC setting demonstrated high interest in using antibiograms to guide empiric antibiotic therapy and address AMR. Despite logistical and infrastructural challenges, tailored training and stakeholder engagement may facilitate the successful development and use of antibiograms in similar resource-limited settings.

Identifiers

PMID41306698
PMCPMC12645232

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.