Pharmacy practice research, Evidence-based practice, Middle East, Arab countries, Recommendation

Background: Inappropriate use of antimicrobials in both humans and animals is a key driver of antimicrobial resist‑ ance (AMR). In addition, human behaviours such as poor disposal of antimicrobials in the environment can increase their exposure to microbes which can impact on humans and animals. However, evidence on access, use and disposal of antimicrobials for humans and animals at community level in Uganda is limited. This study therefore explored access, use and disposal of antimicrobials among humans and animals in Wakiso district, Uganda. Methods: A qualitative study was conducted that involved focus group discussions (FGDs) and key informant inter‑ views (KIIs). Participants of the FGDs were community health workers (CHWs) and farmers involved in animal hus‑ bandry, while key informants included: ofcials from the Ministry of Health; Ministry of Agriculture, Animal Industry and Fisheries; human and animal health professionals; district health ofcials; and members of the national AMR sur‑ veillance committee. Twelve FGDs were held (8 for CHWs and 4 for farmers) while 15 KIIs were conducted. Thematic analysis in NVivo (version 12) was performed. Results: Five main themes emerged from the study: access to antimicrobials in humans; access to antimicrobials in animals; use of antimicrobials in humans; use of antimicrobials in animals; and disposal of antimicrobials. Community members mainly accessed antimicrobials for humans from public health facilities such as government health centres, as well as private facilities, including drug shops and clinics. Antimicrobials for animals were obtained from veterinary practitioners and drug shops (both for humans and veterinary). Examples of inappropriate use of antimicrobials in both humans and animals was evident, such as sharing antibiotics among household members, and giving humanprescribed antimicrobials to food-producing animals as growth promoters. While some CHWs returned unused anti‑ microbials to public health facilities for proper disposal, community members mainly disposed of antimicrobials with general household waste including dumping in rubbish pits. Conclusions: There is a need to increase awareness among the population on proper access, use and disposal of antimicrobials for both humans and animals. 

Background: Inappropriate use of antimicrobials in both humans and animals is a key driver of antimicrobial resist‑ ance (AMR). In addition, human behaviours such as poor disposal of antimicrobials in the environment can increase their exposure to microbes which can impact on humans and animals. However, evidence on access, use and disposal of antimicrobials for humans and animals at community level in Uganda is limited. This study therefore explored access, use and disposal of antimicrobials among humans and animals in Wakiso district, Uganda. Methods: A qualitative study was conducted that involved focus group discussions (FGDs) and key informant inter‑ views (KIIs). Participants of the FGDs were community health workers (CHWs) and farmers involved in animal hus‑ bandry, while key informants included: ofcials from the Ministry of Health; Ministry of Agriculture, Animal Industry and Fisheries; human and animal health professionals; district health ofcials; and members of the national AMR sur‑ veillance committee. Twelve FGDs were held (8 for CHWs and 4 for farmers) while 15 KIIs were conducted. Thematic analysis in NVivo (version 12) was performed. Results: Five main themes emerged from the study: access to antimicrobials in humans; access to antimicrobials in animals; use of antimicrobials in humans; use of antimicrobials in animals; and disposal of antimicrobials. Community members mainly accessed antimicrobials for humans from public health facilities such as government health centres, as well as private facilities, including drug shops and clinics. Antimicrobials for animals were obtained from veterinary practitioners and drug shops (both for humans and veterinary). Examples of inappropriate use of antimicrobials in both humans and animals was evident, such as sharing antibiotics among household members, and giving humanprescribed antimicrobials to food-producing animals as growth promoters. While some CHWs returned unused anti‑ microbials to public health facilities for proper disposal, community members mainly disposed of antimicrobials with general household waste including dumping in rubbish pits. Conclusions: There is a need to increase awareness among the population on proper access, use and disposal of antimicrobials for both humans and animals.