Study title

This study used a qualitative interview design in Sri Lanka, South Africa and the UK. Semi-structured interviews were conducted between 2017 and 2018. The topic guide contained 17 questions about antibiotic prescribing decisions with a focus on broad spectrum antibiotics (BSA) versus narrow spectrum antibiotics (NSA) prescriptions and participants’ risk perceptions of antibiotic resistance. Antimicrobial resistance is one of the largest and most widely-acknowledged problems in 21st century medicine. Attempts to change the ways antibiotics are prescribed, in order to tackle the problem of antimicrobial resistance, have met with variable success. This is partly because the prescription of antibiotics is influenced by many social, cultural and organisational factors, and those prescribing antibiotics have to balance competing interests, values and short and long term benefits when making decisions. Healthcare providers have a responsibility both to individual patients and to 'society at large', and since there is often not a 'technical' solution to problems with prescribing, decisions are usually based on moral values and the customs of the healthcare community. Therefore attempts to change the ways antibiotics are prescribed will be more effective if they take these social factors into account. These social factors, and thus decisions made by individuals about prescribing antibiotics, are strongly influenced by the local and national context. By comparing attitudes to prescribing antibiotics in England, Sri Lanka, and South Africa this study will consider and predict the influence of different contextual factors on various attempts to change the ways antibiotics are prescribed. This will make it easier to assess which attempts will be successful and could be repeated in different international contexts. Models, which take these factors into account, can be used to predict how changes in individual behaviour, social, cultural, or economic factors will impact on...