Skip to main content

Table 4 Antibiotic resistance: themes, subthemes, categories and exemplar quotations

From: Antibiotic stewardship program in Pakistan: a multicenter qualitative study exploring medical doctors’ knowledge, perception and practices

Subthemes Categories Quotations
Alarming situation Escalating resistance against various infectious disease R3: Drug resistance is the major problem. In quinolone here drug resistance is up to 48% and this is very alarming. While sitting in South East Punjab, even in tuberculosis resistance has increased a lot.
R4: I am working in neonatology unit most of the neonates are resistance to most of the broad spectrum antibiotics. if we see culture reports you can see that bacteria are resistant to 90% drugs.
Reasons of resistance Frequent use of antibiotics for minor ailments R2: There is no need of antibiotics in viral infection like flu, and viral diarrhea in children, but antibiotics are used and prescribed for such ailments.
Demand of antibiotic by patient for minor ailments R4:Doctor just give them painkiller and then they ask why you have not given us antibiotic.
Improper dosing and poor compliance R6: Patient does not take medicine in exact dose and for complete duration. Patients take it for 2 or 3 days and discontinue because of many reasons.
Lack of qualified professionals R8: I worked in primary healthcare center. There antibiotics are used irrationally specifically in children by quacks, who are non-qualified and not licensed to prescribe.
Limited number of antibiotics in public healthcare sector R3: In quinolone if we require ciprofloxacin we sometimes get moxifloxacin. And in the same way we do not get the required dosage form. Dose cannot be adjustment. We have not many options available.
Lack of experience drives inappropriate use R3: There is no guidance for health care professionals. Junior doctors (having little or no experience) use broad spectrum antibiotics for minor infections.
Challenges associated with antibiotic resistance Threat to effective antibiotic options for treatment
Expensive drugs are the only option
R7: In next 10 years more than 60% antibiotics will become resistant and useless. After some years it may be impossible to treat patients with antibiotics that are available now.
R9: New antibiotics are costly and new generations are not easily available.
Effect on patient
• Recurrent infection
• Financial burden on patient
R1: Patients suffer financially and ends up having recurrent infection.
R3: Patient remains untreated because we have limited options. Patients cannot afford to buy purchase new antibiotics from market and they end up having recurrent infection.