Table 7 Implementation of antibiotic stewardship programme: Barriers, suggestions and future benefits: themes, subthemes, categories and exemplar quotations

Barriers to successful implementation

Workshops on antibiotic stewardship were not conducted

R3: There are very few people in this setting who talk about this or know about this. But no one owns it and its importance is neglected. No awareness workshop has been conducted regarding this programme in this setting.

Lack of proper audit system

R5: Accessibility to antibiotics is very easy that everybody can prescribe it like dispenser, junior doctors, trainee doctors, etc.

Lack of updated knowledge for qualified professionals

R8: Doctors are prescribing medicines that are not necessary and even those which are no more used in many other countries and are not necessary and no guidance for health care professionals is available.

Unavailability of antibiotic use guidelines and hospital antibiogram

R9: The hospital did not provide us antibiotic use guidelines.

R15: There is no antibiogram available in hospital to guide us about resistant organisms and treatment options.

R3: Our hospital has no specific guidelines. For bronchitis we follow British Thoracic Society guidelines.

Suggestions

Strict enforcement of ongoing and new legislations

R4: We can implement this programme by bringing policies and it will require a lot of effort and home work. We should also make our public and physicians aware that antibiotics are not those medicines which you should use causally.

Active participation of health care professionals

R1: General practitioner should be made aware about rational use because patients visit them first. Pharmacist and doctor should collaborate and work together to ensure safe use of antibiotics.

Awareness among general public about antibiotic resistance and proper use

R5: We should educate our public that they should avoid self-medication of antibiotics and should not take it from unqualified professional.

Future benefits of antibiotic stewardship programme

Might help in current issue of antibiotic resistance

Helps in rational prescribing

R4: Right medicine will be given to patient.

R7: It will educate doctors about latest guidelines and about resistance of antibiotics and by utilizing that awareness we can save our people from further resistance.