A national knowledge exchange workshop organized by the Infectious Disease Institute (IDI) has raised serious concerns over the rising threat of Antimicrobial Resistance (AMR) in Uganda, revealing troubling trends in antibiotic misuse across the health sector.
According to data presented during the workshop, by Centres for Antimicrobial Optimisation Network (CAMO-Net) 58.7% of hospitalized patients in Uganda received antibiotics between 2020 and 2023, yet nearly a quarter of these prescriptions lacked clinical justification.
Even more worrying, only 3% were based on laboratory-confirmed diagnoses.
The over-reliance on “Watch” antibiotics, such as Ceftriaxone, accounted for 44.4% of prescriptions, defying World Health Organization (WHO) guidelines that recommend 60% of prescriptions come from the safer “Access” group, including drugs like Ampicillin.
Participants underscored the urgent need to strengthen diagnostic laboratories, enforce WHO’s AWaRe classification system, and improve oversight of prescribing practices to curb rising misuse.
The misuse of antibiotics was particularly severe among people with HIV (PWH). From 2016 to 2022, only 12% of antibiotic prescriptions for this group were deemed appropriate.
Alarmingly, half of the cases lacked a clear diagnosis, while 39% involved incorrect drug classes. Though a prescriber training program in 2018 briefly improved practices, these gains were reversed during the COVID-19 pandemic.
Experts called for targeted antimicrobial stewardship (AMS) and enhanced clinical documentation for PWH.
Dr Andrew Kambugu, the Executive Director of the Infectious Disease Institute lead of the CAMO-Net,Uganda hub, affirmed that insights from the workshop will be advanced in collaboration with stakeholders.
The economic burden of AMR was also brought to light. Each resistant infection costs Uganda an estimated $77,391 annually per patient, with 89% of the costs absorbed by the health system.
Resistant infections were linked to longer hospital stays and higher mortality rates. Gender disparities were also noted, with women bearing 12% more informal care costs and 34% greater losses in productivity than men.
Systemic issues—such as weak lab infrastructure, frequent stockouts, and poor enforcement of AMR policies—were identified as root causes of the crisis. The COVID-19 response, while necessary, also disrupted existing AMR control programs, further exposing vulnerabilities in Uganda’s healthcare system.
Health experts concluded the workshop with a call to action: invest in surveillance, strengthen regulation, and prioritize public education to combat the escalating AMR threat.