Ramdas Nishana, Meyer Johanna C, Schellack Natalie, Godman Brian, Turawa Eunice Bolanle, Campbell Stephen M
Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
BMJ Open. 2025 Feb 2;15(1):e088769. doi: 10.1136/bmjopen-2024-088769.
Inappropriate antibiotic use in (primary healthcare, PHC) settings fuels antimicrobial resistance (AMR), threatens patient safety and burdens healthcare systems. Patients' knowledge, attitudes, motivations and expectations play a crucial role in antibiotic use behaviour, especially in low-income and middle-income countries including South Africa. There is a need to ensure measures of antibiotic use, interventions and future guidance reflect cultural, community and demographic issues associated with patient views to reduce inappropriate use of antibiotics and associated AMR. The objective of this scoping review is to identify key themes surrounding knowledge, attitudes, motivations and expectations among patients and community members regarding antimicrobial use in PHC settings especially in low-income and middle-income countries.
This scoping review employs a comprehensive search strategy across multiple electronic databases, including OVID, Medline, PubMed and CINHAL, to identify studies addressing patients or community members seeking care at PHC facilities and exploring key drivers of antimicrobial use. The Covidence web-based platform will be used for literature screening and data extraction and the Critical Appraisal Skills Programme qualitative checklist will assess the quality of qualitative papers. Anticipated results will provide an overview of the current evidence base, enabling identification of knowledge gaps. A narrative synthesis of findings will summarise key themes and patterns in patients' knowledge, attitudes, motivations and expectations related to antibiotic use across studies while considering methodological diversity and limitations.
Ethics approval is not required for this scoping review. The findings of this scoping review will be disseminated through publication in a peer-reviewed journal, presentation at relevant conferences and workshops, and collaboration with policy-makers and healthcare stakeholders.
基层医疗保健机构中抗生素的不当使用助长了抗菌药物耐药性（AMR），威胁患者安全并增加了医疗系统的负担。患者的知识、态度、动机和期望在抗生素使用行为中起着至关重要的作用，尤其是在包括南非在内的低收入和中等收入国家。有必要确保抗生素使用的衡量标准、干预措施和未来指导能够反映与患者观点相关的文化、社区和人口问题，以减少抗生素的不当使用及相关的抗菌药物耐药性。本综述的目的是确定围绕患者和社区成员在基层医疗保健机构中使用抗菌药物的知识、态度、动机和期望的关键主题，特别是在低收入和中等收入国家。
本综述采用全面的检索策略，在多个电子数据库中进行检索，包括OVID、Medline、PubMed和CINHAL，以确定针对在基层医疗保健机构寻求治疗的患者或社区成员并探索抗菌药物使用关键驱动因素的研究。基于网络的Covidence平台将用于文献筛选和数据提取，批判性评估技能计划定性检查表将评估定性论文的质量。预期结果将概述当前的证据基础，以便确定知识差距。对研究结果的叙述性综合将总结各项研究中患者与抗生素使用相关的知识、态度、动机和期望的关键主题和模式，同时考虑方法的多样性和局限性。
本综述无需伦理批准。本综述的结果将通过在同行评审期刊上发表、在相关会议和研讨会上展示以及与政策制定者和医疗保健利益相关者合作来传播。
