Guest blog by: Oliver Angom, CAMO-Net Fellow, Uganda hub
Antimicrobial resistance (AMR) is a silent pandemic, disproportionately affecting low- and middle-income countries (LMICs). A recent study at the Infectious Diseases Institute clinic, led by Dr Barbara Castelnuovo and Dr Noela C. Owarwo, and coordinated by Dr Brian Otaalo, revealed staggering findings: 88% of prescriptions made were deemed inappropriate.
In response to the urgent threat of antimicrobial resistance and the troubling rates of inappropriate antibiotic use, a behavioural intervention is being implemented at the Infectious Diseases Institute, Prevention, Care, and Treatment Clinic. This initiative is guided by Dr Castelnuovo and Dr Owarwo and executed by Dr Oliver Angom, Dr Brian Otaalo, Solome Naluwu, and the PCT team. It embodies the spirit of multidisciplinary collaboration and the principles of antimicrobial stewardship to optimise prescribing practices.
Using the behavioural change wheel, the team has identified key components of the intervention to improve capability, motivation, and opportunity, aiming for appropriate prescribing. This includes raising awareness about antimicrobial resistance and stewardship through physical and digital charts, educating prescribers and patients, providing regular team feedback and face-to-face interactions, and highlighting Uganda Clinical guidelines during weekly journal clubs. Evidence-based prescribing practices that favour targeted, first-line therapies and discourage habitual broad-spectrum use are also emphasised. Furthermore, patient education is prioritised to help individuals understand when antibiotics are necessary and when supportive care is sufficient.
The preliminary results of the intervention show the impact of simple yet effective solutions in addressing antimicrobial resistance. Notably, there has been a decrease of over 20% in unnecessary antimicrobial prescriptions, and the appropriateness of antimicrobial prescribing has risen to over 80%. By fostering a stewardship culture based on evidence, accountability, and multidisciplinary collaboration, the clinic has positioned itself as a leading local authority in the combating against antimicrobial resistance.
While the challenge of AMR continues, these early achievements show that strategic, data-driven interventions are effective even in modest healthcare settings. From the implementation of this intervention, there is a clear need to secure sustainable funding and demonstrate long-term commitment, ensuring that its impact can be realized and maintained. Every informed prescription strengthens and resiliencies a health system.
Let’s work together to protect antibiotics for the future!
