Barriers to implementing antimicrobial stewardship programs in three low- and middle-income country tertiary care settings: findings from a multi-site qualitative study

  27 March 2021

Antimicrobial resistance has been named as one of the top ten threats to public health in the world. Hospital-based antimicrobial stewardship programs (ASPs) can help reduce antimicrobial resistance. The purpose of this study was to determine perceived barriers to the development and implementation of ASPs in tertiary care centers in three low- and middle-income countries (LMICs).

Our study highlighted several important barriers to implementing ASPs that were shared between three tertiary care centers in LMICs. Improving drug availability, enhancing availability of and trust in microbiologic data, creating local guidelines, and providing education to physicians regarding antimicrobial prescribing are important steps that could be taken by ASPs in these facilities.

Author(s): Robert Rolfe Jr, Charles Kwobah, Florida Muro, Anushka Ruwanpathirana, Furaha Lyamuya, Champica Bodinayake, Ajith Nagahawatte, Bhagya Piyasiri, Tianchen Sheng, John Bollinger, Chi Zhang, Truls Ostbye, Shamim Ali, Richard Drew, Peter Kussin, Deverick J. Anderson, Christopher W. Woods, Melissa H. Watt, Blandina T. Mmbaga & L. Gayani Tillekeratne
Effective Surveillance  


Unrestricted financial support by:


Antimicrobial Resistance Fighter Coalition

Bangalore Bioinnovation Centre



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