Antibiotic Stewardship: Twenty Years in the Making (2)

4 February, 2019

Hi Neil et al.

I conducted research into clinician knowledge attitudes and practices in relation to antibiotic prescribing and stewardship on Zanzibar a few years ago. We found that most if not every clinic had access to the National Clinical-Therapeutic Guidelines and most people said they would use that as a source of information to make prescribing decisions.

However, we found issues with updating the books and we also found that most people would be at least as likely to defer to a colleague as to use the guidelines.

We also found a lot of people felt that antimicrobial resistance was an important problem globally, but less so for them locally, which would be a worrying trend if repeated globally.

Our research was only on a small scale in one location but a review of the literature at the time didn't reveal very much research on AMR from developing economies. Maybe this is something that needs to be repeated at a larger scale? I would be interested to know people's thoughts.

I'm also personally very interested in the point raised about the socio-cultural aspects of antibiotic prescribing, and how conversations about medications (including antibiotics) can be driven by evidence-based data re: benefits and risks. I would be very interested to know if anyone else is actively researching that topic?

All the best,


HIFA profile: David Neal is Founder of Vesalian, United Kingdom. He is a doctor, with a degree in behavioural science with anthropology. He is also working on ways to support shared, data-driven decision-making in healthcare, by making the best information, the easiest information for patients and professionals to access, understand and remember. Email address: