A qualitative study exploring basis for antibiotics prescription without microbiological investigations, Dar es Salaam Tanzania

Abstract

Background Prescription of antibiotics based on microbiological investigations is a commendable rational use of antibiotics and help in fighting the spread of resistance. Although shortage of microbiology laboratory is indicated to impair this practice but prescription without microbiological investigation has been reported even in settings with laboratory facilities. Methods Semi structured key informant interviews with 31 prescribing medical doctors in Dar es Salaam, Tanzania were conducted from January to June 2019. The purpose of the interviews was to obtain the insight into the prescriptions of antibiotics without microbiological investigations especially in hospitals with laboratory facilities. Results Majority of participants (26/31) were ready to prescribe antibiotics without microbiological investigations. In addition, a total of four major themes were identified as the basis for this practice; i) clinical condition of the patient ii) past experience with the clinical condition and/or patient iii) an intention to prevent the spread of infection and iv) patient’s history and physical examination were adequate to establish the management plan. Conclusion In recognition of the urgent need to improve antibiotic use in hospitals, this study highlights the need to implement hospital Antibiotic Stewardship Programs in Dar es Salaam, Tanzania.