Evidence map›Paper›PMID 41760856›Full record

ArticleScientific reports2026

Barriers to and facilitators of adherence to evidence-based standard antimicrobial treatment guidelines among physicians in Ethiopia: a formative qualitative study.

Minyahil Tadesse Boltena, Mirkuzie Woldie, Ziad El-Khatib, Yibeltal Siraneh, Abraham Sahilemichael Kebede, Zelalem Tadesse, Wondwossen Amanuel, Sudhakar Morankar

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Minyahil Tadesse BoltenaEthiopian Evidence Based Health Care Centre: A Joanna Briggs Institute Center of Excellence, Health Behavior and Society Department, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia. minyahil.tadesse@ahri.gov.et.ORCID http://orcid.org/0000-0002-5081-1480
Mirkuzie WoldieHealth Policy and Management Departments, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Ziad El-KhatibGlobal Public Health Department, Karolinska Institute, Solna, Sweden.
Yibeltal SiranehHealth Policy and Management Departments, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Abraham Sahilemichael KebedeLero SFI Research Centre for Software, Health Research Institute, University of Limerick, Limerick, Ireland.
Zelalem TadesseMinistry of Health, Addis Ababa, Ethiopia.
Wondwossen AmanuelAfrica Centers for Diseases Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.
Sudhakar MorankarEthiopian Evidence Based Health Care Centre: A Joanna Briggs Institute Center of Excellence, Health Behavior and Society Department, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rational antimicrobial prescribing is critical to curb antimicrobial resistance, yet adherence to standard antimicrobial treatment guidelines remains inconsistent in Ethiopia. Understanding the barriers and facilitators influencing physicians’ adherence is essential to inform context-appropriate interventions. We conducted a formative qualitative study from April to June 2023 in 20 public hospitals across four Ethiopian regions. Using maximum variation purposive sampling, 47 physicians participated in in-depth interviews. Data were analyzed using the Theoretical Domains Framework embedded within the COM-B model, with thematic coding in MAXQDA and reporting guided by COREQ. Physicians faced multiple barriers to standard antimicrobial treatment guidelines adherence. The guidelines were often bulky, outdated, and misaligned with patient needs. Limited training, low confidence, and resistance from senior clinicians further reduced adherence. Delayed dissemination, restricted access to medicines, heavy clinical workloads, and inconsistent practices in private facilities compounded these challenges. Facilitators supporting adherence included peer collaboration, routine clinical audits, trust in locally developed guidelines, and professional motivation. Study participants recommended developing smartphone application of standard antimicrobial treatment guidelines for point-of-care access. Study participants highlighted digital solutions, such as mobile STG applications, to enhance accessibility and recommended interventions including training, digital access, audits, and policy enforcement. Adherence to standard treatment guidelines is influenced by individual, institutional, and system-level factors. Updating and digitalizing guidelines, integrating adherence into continuous professional development training, strengthening institutional support, and implementing policy measures are key strategies to improve adherence and rational antimicrobial prescription.

Indexed as

Anti-Bacterial AgentsAnti-Infective AgentsGuideline AdherencePhysiciansPractice Patterns, Physicians'Adherence InterventionsAdultEthiopiaFemaleHumansMalePractice Guidelines as TopicQualitative ResearchAnti-Bacterial AgentsAnti-Infective AgentsAntimicrobial stewardshipCOM-B modelEthiopiaPhysicians’ adherenceQualitative studyRational antimicrobial prescriptionStandard treatment guidelines (STGs)

Identifiers

PMID41760856
PMCPMC13048980

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.