Is community testing and awareness of AMR and AMU important in Uganda?

This observational, mixed methods pilot study will measure the causes and prevalence of resistance in patients with acute urinary tract infections (UTIs) presenting at community drug retail outlets (CDROs) and outpatient clinics (OPDs), together with patient and pharmacists behaviours around the use and dispensing of antibiotics in two socioeconomically differing neighbourhoods in Kampala, Uganda over 24 months. We will investigate the causes, treatment, and outcome of acute UTIs in patients and compare these with the resistance profiles reported to WHO-GLASS. Our secondary aims are to 1) determine the prescribing and dispensing patterns in CDROs/OPDs for acute UTIs; 2) explore the demographic, illness history, and housing status of patients seeking treatment; 3) determine the prevalence of multi-drug resistance in carriage organisms from patients, exploring links between socioeconomic factors, antibiotic resistance, and antibiotic use in these neighbourhoods. Simple frameworks and surveys on dispensing practices, socioeconomic and cultural factors encouraging appropriate antibiotic use will be devised and freely available. This data will provide evidence on the patterns of antibiotic use and AMR outside the healthcare settings while helping formulate solutions through improving awareness about inappropriate/misuse of antibiotics locally, feedback of results to the community and hospitals, local decision-makers, and policymakers, and international efforts on AMR.