Tupistra chinensis polysaccharides remitted intestinal inflammation induced by LPS via regulating gut microbiota.

BackgroundIncreasing awareness of and understanding about antimicrobial resistance (AMR), promoting changes in behavior, and monitoring of AMR in the community are challenging, as AMR is associated with many contributing factors that are difficult to assess individually. This study aimed to determine the effectiveness of a community-based AMR campaign for improving awareness, understanding, and behavior relating to antibiotic use and AMR in Thailand and to assess if fecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae could be a proxy composite indicator of AMR in the community.MethodsThis study was conducted in 4 communities that are home to approximately 400 000 people. A self-administered questionnaire on awareness, understanding, and behavior relating to antibiotic use and AMR was responded to by 20 521 and 19 634 adults before and immediately after the AMR campaign, respectively, at the household level. Fecal samples were collected from 534 adults before the AMR campaign and from 709 adults at 18 months after the AMR campaign to determine presence of ESBL-producing Enterobacteriaceae.ResultsAwareness, understanding, and behavior relating to antibiotic use and AMR, as assessed by a self-administered questionnaire, were significantly improved after the AMR campaign. The fecal carriage rate of ESBL-producing Enterobacteriaceae decreased from 66.5% before to 44.6% after the AMR campaign (P < .01).ConclusionsOur AMR campaign was effective for improving awareness, understanding, and behavior relating to antibiotic use and AMR among people in the community at the household level, and the prevalence of fecal carriage of ESBL-producing Enterobacteriaceae seemed to be decreased after the AMR campaign. Fecal carriage rate of ESBL-producing Enterobacteriaceae may be a proxy composite indicator of AMR in the community.

Understanding how farmers use antimicrobials and their awareness and beliefs about antimicrobial resistance (AMR) is essential to improve antimicrobial usage (AMU) practices and combat AMR on dairy farms. A cross-sectional online survey was carried out to identify the factors affecting attitudes, knowledge and behaviour of Scottish dairy producers regarding prudent AMU and the emergence of AMR in livestock. The survey was designed based on the earlier findings of two focus groups and was disseminated online via multiple methods (e.g., social media; farming press). Participation was voluntary and answers were obtained from 61 respondents (7.3% of the total population of Scottish dairy farmers). Logistic and ordinal regression analyses were performed to identify predictors for farmers’ level of knowledge about antimicrobials and AMR, AMU behaviour and attitudes towards AMR mitigation. Associations were described with odds ratios (OR) and the associated 95% confidence intervals (95% CI). Farmers were more likely to have better knowledge of antimicrobials and AMR if they had undertaken a university degree (OR = 28.28, P < 0.001), worked with mixed livestock (dairy plus sheep/beef) (OR = 4.82, P < 0.05), and trusted only veterinarians’ information about responsible AMU (OR = 4.42, P < 0.05). In the survey disease scenarios, younger farmers were less likely to be classed as low antimicrobial users (OR = 0.18, P < 0.05) compared to older farmers. Respondents working on larger herds were also less likely to be low antimicrobial users compared to those working on smaller herds (OR = 0.12, P < 0.01). Conversely, farmers who did not consider economic factors (e.g., cost and withdrawal period) in antimicrobial choice were more likely to be classed as low antimicrobial users (OR = 6.17, P < 0.01). Respondents were more likely to show positive attitudes towards AMR mitigation if they worked in larger (OR = 4.67, P < 0.05) or organic dairy farms (OR = 18.35, P < 0.05). These results suggest that several practices, social, demographic, and economic factors influence dairy farmers’ perception and awareness of AMR and AMU. Efforts should be made to consider these variables when developing strategies to improve AMU in dairy farming. Veterinarians and advisors should focus AMU training and AMR awareness-raising activities towards younger, less experienced farmers as well as those with a lower educational qualification (high school vs. university degree). This study can inform the development of targeted educational initiatives to encourage responsible AMU on dairy farms.

BackgroundCommunicating about antimicrobial resistance (AMR) and antimicrobial stewardship (AMS) requires technical knowledge, consideration of audience values and appropriate identification of communication strategies for multiple audiences. Within the context of animal agriculture, communicating about AMR represents an important and complex endeavour for veterinarians, governmental agencies, producers and the industry to convey policy and practice information regarding the use of antimicrobials in food animals.ObjectivesTo assess the science communication challenges related to AMR by identifying the motivations, goals and struggles of animal agriculture stakeholders when communicating about AMR and AMS.MethodsParticipants attending a meeting on AMR communication in animal agriculture (N = 80) completed a workshop on science communication, including small group meetings with oral/written comments collected. Participants included veterinarians, government agency representatives, industry stakeholders and producers.ResultsResults indicated participants believed providing more accurate information would resolve misunderstanding and concern about AMR to other stakeholders, counter to recommendations of science communicators. Other participants noted beliefs about the utility of stories in trying to explain how AMS is normative and consistent with the values of all parties interested in animal agriculture. Participants noted the importance of public engagement, even if the participants’ perceived target audiences did not include the public.ConclusionsCommunicating about AMR and AMS in animal agriculture contexts provide unique challenges. Few evidence-based recommendations are available for science communicators in these contexts and more research is needed to improve the quality of communication about AMR and AMS in animal agriculture.

Antimicrobials resistance and irrational use of antimicrobials (AMs) are a worldwide problem. The objective of this study is to assess knowledge, attitudes and practices about an-timicrobial resistance (AMR) and AM prescribing among physicians in the northern districts of the occupied Palestinian territories. A cross-sectional study using a self-administered ques-tionnaire was conducted at governmental hospitals in the northern districts of the occupied Palestinian territories to assess knowledge, attitudes and practice of physicians about antibi-otic prescribing and AMR. This study was conducted in the period starting October 2016 until April of 2017.The average knowledge score was 5 out of 7(SD + 0.17). The vast majority (95.8%) strongly agreed that AMR is a worldwide problem. Although (84.9%) agreed that AMR is a problem in their daily practice, about (69.2%) of them did not know the rate of AMR in their hospitals. Confidence about AMs prescribing was higher among residents than attending physicians (47%, 40%, respectively). With respect to the sources of information, the majority of participants (78.9%) found that the internet is a very useful source of infor-mation while more than half (52.4%) sometimes ask their colleagues. The pressure which the patients put on the physicians to prescribe AMs (54.2% in the community versus 25.9% in the hospital setting) and the availability of AMs in hospitals (26%) contributed to AM over-use. The majority of participants (99.4%) were interested in more AMs prescribing educa-tional programs and local AM guidelines (81.3%).This study highlighted the areas of weak-nesses that need to be addressed for future AM prescribing interventions such as increasing awareness about local AMR rates, preparation and dissemination of local AM guidelines based on local AMR data, as well as raising the general public’s awareness about AMs and AMR and exploring the possibilities of internet-based training.

The human toll-like receptor 4 (TLR4) pathway is activated in response to lipopolysaccharide (LPS), and subsequent signal transductions lead to the production of cytokines such as tumor necrosis factor-α (TNF-α) by innate immune cells. Defects in innate immune response may contribute to the overproduction of TNF-α leading to systemic inflammation and diseases. Thus, the innate immune response needs to be tightly regulated by elaborate mechanisms to control its onset and termination. LPS tolerance is a state of hyporesponsiveness to subsequent LPS challenge and is achieved by monocytic cells after prolonged exposure to LPS. In this report, kinetics of endotoxin-responsive microRNAs expression analysis revealed a unique pattern of gradual increase for miR-146a starting 4 h after LPS stimulation in THP-1 cells and continued up to 35-fold over 24 h. Conversely, TNF-α increased up to 4 h and then decreased gradually implicating a negative correlation with miR-146a progression. The characteristic up-regulation of miR-146a toward subsequent LPS challenge in THP-1 cells was studied. Strikingly, microRNA expression analysis during the tolerized state of THP-1 cells showed only miR-146a overexpression suggesting its important role in LPS tolerance. In addition, LPS tolerance was dependent on a LPS-priming dose and associated miR-146a up-regulation. LPS-tolerized cells were observed to regain responsiveness in TNF-α production 22 h after LPS removal correlating with a decrease in miR-146a level. Transfection of miR-146a into THP-1 cells mimicked LPS priming, whereas transfection of miR-146a inhibitor largely abolished LPS tolerance. Thus our studies demonstrated that miR-146a is critical for the in vitro monocytic cell-based endotoxin tolerance.

Elevation of ketone bodies occurs frequently after parturition during negative energy balance in high yielding dairy cows. Previous studies illustrated that hyperketonemia interferes with metabolism and it is assumed that it impairs the immune response. However, a causative effect of ketone bodies could not be shown in vivo before, because spontaneous hyperketonemia comes usually along with high NEFA and low glucose concentrations. The objective was to study effects of beta-hydroxybutyrate (BHBA) infusion and an additional intramammary lipopolysaccharide (LPS) challenge on metabolism and immune response in dairy cows. Thirteen dairy cows received intravenously either a BHBA infusion (group BHBA, n=5) to induce hyperketonemia (1.7 mmol/L), or an infusion with a 0.9 % saline solution (Control, n=8) for 56 h. Infusions started at 0900 on day 1 and continue up to 1700 two days later. Two udder quarters were challenged with 200 μg Escherichia coli-LPS 48 h after the start of infusion. Blood samples were taken one week and 2 h before the start of infusions as reference samples and hourly during the infusion. Liver and mammary gland biopsies were taken one week before the start of the infusion, 48 h after the start of the infusion, and mammary tissues was additionally taken 8 h after LPS challenge (56 h after the start of infusions). Rectal temperature (RT) and somatic cell count (SCC) was measured before and 48 h after the start of infusions and hourly during LPS challenge. Blood samples were analyzed for plasma glucose, BHBA, NEFA, triglyceride, urea, insulin, glucagon, and cortisol concentration. The mRNA abundance of factors related to potential adaptations of metabolism and immune system was measured in liver and mammary tissue biopsies. Differences between blood constituents, RT, SCC, and mRNA abundance before and 48 h after the start of infusions, and differences between mRNA abundance before and after LPS challenges were tested for significance by GLM of SAS procedure with treatment as fixed effect. Area under the curve was calculated for blood variables during 48 h BHBA infusion and during the LPS challenge, and additionally for RT and SCC during the LPS challenge. Most surprisingly, both plasma glucose and glucagon concentration decreased during the 48 h of BHBA infusion (P<0.05). During the 48 h of BHBA infusion, serum amyloid A mRNA abundance in mammary gland was increased (P<0.01), and haptoglobin (Hp) mRNA abundance tended to increase in cows treated with BHBA compared to control group (P= 0.07). RT, SCC, and candidate genes related to immune response in the liver were not affected by BHBA infusion. However, during LPS challenge the expected increase of both plasma glucose and glucagon concentration was much less pronounced in the animals treated with BHBA (P<0.05) and also SCC increased much less pronounced in the animals infused with BHBA (P<0.05) than in the controls. An increased BHBA infusion rate to maintain plasma BHBA constant could not fully compensate for the decreased plasma BHBA during the LPS challenge which indicates that BHBA is used as an energy source during the immune response. In addition, BHBA infused animals showed a more pronounced increase of mRNA abundance of IL-8, IL-10, and citrate synthase in the mammary tissue of LPS challenged quarters (P<0.05) than control animals. Results demonstrate that infusion of BHBA affects metabolism through decreased plasma glucose concentration which is likely related to a decreased release of glucagon during hyperketonemia and during additional inflammation. It also affects the systemic and mammary immune response which may reflect the increased susceptibility for mastitis during spontaneous hyperketonemia. The obviously reduced gluconeogenesis in response to BHBA infusion may be a mechanism to stimulated the use of BHBA as an energy source instead of glucose, and/or to save oxaloacetate for the citric acid cycle instead of gluconeogenesis and as a consequence to reduce ketogenesis.

This study was conducted to determine whether L-arginine (Arg) supplementation could improve intestinal function in weaned pigs after an Escherichia coli lipopolysaccharide (LPS) challenge. Treatments included: i) non-challenged control (CONTR, pigs fed a control diet and injected with sterile saline); ii) LPS-challenged control (LPS, pigs fed the same control diet and challenged by injection with Escherichia coli LPS); iii) LPS+0.5% Arg (pigs fed a 0.5% Arg diet and challenged with LPS); and iv) LPS+1.0% Arg (pigs fed a 1.0% Arg diet and challenged with LPS). On d 16, pigs were administrated with LPS or sterile saline. D-xylose was orally administrated at 2 h following LPS challenge, and blood samples were collected at 3 h following LPS challenge. At 6 h post-challenge, pigs were sacrificed and intestinal mucosa samples were collected. Supplementation of Arg attenuated LPS-induced damage in gut digestive and barrier functions, as indicated by an increase in ileal lactase activity, and duodenal and ileal diamine oxidase activities (p<0.05). Arg administration also prevented the increase of jejunal malondialdehyde content and the decrease of ileal superoxide dismutase activity by LPS challenge (p<0.05). Furthermore, the jejunal nitric oxide level and inducible nitric oxide synthase activity were also improved after Arg supplementation (p<0.05). These results indicate that Arg supplementation has beneficial effects in alleviating the impairment of gut function induced by LPS challenge.

The intestinal health of weanling pigs is often compromised by harmful bacterial agents, leading to inflammation and reduced intestinal integrity. Limited research exists on the effects of spirulina as a bioactive feed additive on weanling pigs. Hence, this study aimed to investigate the effect of spirulina on the growth performance and intestinal health of pigs using a lipopolysaccharide (LPS) challenge model. On d 0, 128 pigs were assigned to one of four groups in a 2 × 2 factorial arrangement of treatments with 2 levels each of spirulina (0 or 5 g SP/kg) and LPS (challenge or no-challenge). There were 8 replicate pens per treatment and 4 pigs per pen. On d 7, pigs were weighed, and pigs in the LPS challenge group were intraperitoneally injected with 100 µg/kg body weight LPS. The other pigs were injected with saline. On d 14, all pigs were weighed. On d 15, one selected pig per pen was again injected with the same amount of LPS or saline. After 4 h, the selected pigs were euthanized, and samples were collected. Data were analyzed using the MIXED procedure of SAS and evaluated for main effects and interactions. There was no dietary spirulina effect on growth performance. However, the LPS challenge reduced (P < 0.05) the body weight and gain-to-feed ratio of pigs. Dietary spirulina increased (P < 0.05) the apparent total tract digestibility (ATTD) of dry matter regardless of the LPS challenge. There was an SP × LPS interaction effect (P < 0.05) on the jejunal villus height, villus perimeter, and villus area. Additionally, there was an SP × LPS interaction (P < 0.05) on serum tumor necrosis factor alpha. Challenge with LPS reduced (P < 0.05) the serum concentration of catalase but increased (P < 0.05) serum c-reactive protein concentration irrespective of dietary spirulina inclusion level. Dietary spirulina increased (P < 0.05) the mRNA expression of jejunal zonula occludens-1. An SP × LPS interaction (P < 0.05) showed that LPS-challenged pigs fed a spirulina-supplemented diet had the highest jejunal superoxide dismutase 2 mRNA expression relative to pigs in the other groups. In summary, dietary spirulina supplementation enhanced antioxidant activity and reduced intestinal inflammation in pigs during an LPS challenge. Dietary spirulina also improved tight junction integrity and dry matter digestibility, irrespective of the LPS challenge.

BackgroundA flood of data is showing that the silent pandemic is no longer silent. It is already here and impacting the entire world and is particularly severe in low- and middle-income countries.ObjectivesTo highlight the scarcity of data about antimicrobial resistance (AMR) in Sudan, which is now devastated by the political unrest. Simultaneously the review is calling attention to the day-to-day deterioration in the infrastructural foundation necessary to combat AMR.MethodsThe review spans different topics related to AMR. It includes data and epidemiology of antimicrobial resistance, awareness and education about AMR, awareness about immunization, healthcare infrastructure, pharmacists’ viewpoints of their current roles in the healthcare.ResultsFew data about AMR are published. Resistance is reported mostly based on phenotypic data. Huge gaps in the knowledge, awareness and the curricula are evidenced to be present even among medical and veterinary students. Inefficiency of regulatory bodies and lack of coordination between them is reported. Published data reflect a wide acceptance of immunization in children under 5 years old. Pharmacists are unsatisfied by their current jobs and are ready to participate better in healthcare.ConclusionsThe radical solutions to AMR entail building robust infrastructure for healthcare and acquiring political will, which are currently and in the foreseeable future impractical and unattainable. However, solution opportunities still exist. I see three main opportunities represented in pharmacists, immunization programmes and non-profit organizations, mainly WHO. A great deal of potential lies in the sector of pharmacists. There is a substantial number of them who are willing to contribute better to healthcare. One example is the effective engagement of pharmacists who are graduating in high qualifications and education while doing minor roles. Their engagement could be incentivized by considering the participation part of their professional growth. Contrary to the case of adults, immunization of children under 5 years is accepted and implemented largely in Sudan even in remote areas. This is the second potential solution that is worthy of investment and would pay off. WHO and similar organizations at the very least could play the role of the missing coordinator, or even better they could devise pioneering know-how programmes ready to be implemented in these countries. In these programmes, WHO will be able to attract a lot of qualified volunteers to participate in awareness and education campaigns. They also could engage higher education institutions and ministries of health.

Background: Communicating about antimicrobial resistance (AMR) to the public is challenging. Methods: We developed a dictionary of terms commonly used to communicate about AMR. For each term, we developed learning points to explain AMR and related concepts in plain language. We conducted a pilot evaluation in 374 high school students in Ubon Ratchathani, Thailand. In three 50-minute sessions, students were asked to answer five true/false questions using a paper-based questionnaire. The first session assessed their understanding of AMR at baseline, the second after searching the internet, and the third after the provision of the printed AMR dictionary and its web address. Results: We developed the AMR dictionary as a web-based application (www.amrdictionary.net). The Thai version of the AMR dictionary included 35 terms and associated learning points, seven figures displaying posters promoting AMR awareness in Thailand, and 66 recommended online videos. In the pretest, the proportion of correct responses to each question ranged from 10% to 57%; 10% of the students correctly answered that antibiotics cannot kill viruses and 57% correctly answered that unnecessary use of antibiotics makes them ineffective. After the internet searches, the proportions of correct answers increased, ranging from 62% to 89% (all p&lt;0.001). After providing the AMR dictionary, the proportions of correct answers increased further, ranging from 79% to 89% for three questions (p&lt;0.001), and did not change for one question (p=0.15). Correct responses as to whether taking antibiotics often has side-effects such as diarrhoea reduced from 85% to 74% (p&lt;0.001). The dictionary was revised based on the findings and comments received. Conclusions: Understanding of AMR among Thai high school students is limited. The AMR dictionary can be a useful supportive tool to increase awareness and improve understanding of AMR. Our findings support the need to evaluate the effectiveness of communication tools in the real-world setting.

Public health messaging about antimicrobial resistance (AMR) sometimes conveys the problem as an epidemic. We outline why AMR is a serious endemic problem manifested in hospital and community-acquired infections.AMR is not an epidemic condition, but may complicate epidemics, which are characterised by sudden societal impact due to rapid rise in cases over a short timescale. Influenza, which causes direct viral effects, or secondary bacterial complications is the most likely cause of an epidemic or pandemic where AMR may be a problem. We discuss other possible causes of a pandemic with AMR, and present a risk assessment formula to estimate the impact of AMR during a pandemic. Finally, we flag the potential impact of genetic engineering of pathogens on global risk and how this could radically change the epidemiology of AMR as we know it.Understanding the epidemiology of AMR is key to successfully addressing the problem. AMR is an endemic condition but can play a role in epidemics or pandemics, and we present a risk analysis method for assessing the impact of AMR in a pandemic.

This study hypothesized that dietary feed additive containing probiotics alter either immune-related serum substances or serum metabolites in Hanwoo heifers. A probiotic treatment was given at 0.5% top-dressing of concentrate diet for 6 months. The change of immunological indicators in the blood was analyzed under LPS (Lipopolysaccharide) challenge. One day before administration of LPS, all heifers were fitted with an indwelling jugular vein catheter for serial blood collections. Both a serum tube and an EDTA-coated tube were collected at 30-min intervals from - 2 to 8 hours relative to the LPS challenge at time 0 (1 ㎍/㎏ of BW). Serum was used for analyzing albumin (ALB), glucose (GLU), total protein (TP), triglycerides (TG), phosphorus (IP), and non-esterified fatty acids (NEFA). Plasma was used for analyzing white blood cell (WBC), red blood cell (RBC), platelet (PLT) and inflammation-related factors (NE, LY, MO, EO, BA, Hb, HCT, MCV, MCH, MCHC, RDW, MPV). There were significant differences in ALB, GLU, TG, IP, and NEFA concentration with the passage of hours post challenge (p 0.05). The level of WBC, EO, LY, and MO were reduced after LPS challenge (p > 0.05). In conclusion, LPS challenge after dietary supplementation of probiotics changed the levels of both serum metabolites and inflammation-related factors. The increase of GLU and TG indicated a probiotics-positive response under LPS challenge (p < 0.05).

BackgroundPharmacists have important antimicrobial stewardship (AMS) roles yet limited literature exists on pharmacists’ knowledge and beliefs about antimicrobial resistance (AMR) and antimicrobials and how these beliefs influence antimicrobial supply in different countries.MethodsA cross-sectional survey was disseminated to pharmacists around the world via the Commonwealth Pharmacists’ Association and related networks. Data were collected on demographics, antibiotic supply practices, and knowledge and beliefs about AMR.ResultsA total of 546 pharmacists responded from 59 countries, most commonly from Africa (41%) followed by Asia (26%) and Oceania (22%). Respondents supplied a mean of 46 ± 81 antibiotic prescriptions/week, 73%±35% of which were given in response to a prescription. Overall, 60.2% dispensed antibiotics at least once without a prescription. Respondents had good knowledge (mean 9.6 ± 1.3 (out of 12), and held positive beliefs about AMR [mean 3.9 ± 0.6 (out of 5)]. Knowledge about antibiotics and beliefs about AMR were positively correlated. The odds of supplying antibiotics without a prescription were 7.4 times higher among respondents from lower income countries [adjusted odds ratio (AOR) = 7.42, 95% CI 4.16–13.24]. Conversely, more positive AMR beliefs were associated with a lower odds of supplying antibiotics without a prescription (AOR = 0.91, 95% CI 0.86–0.95).ConclusionsMost pharmacists had the good knowledge about antibiotics and positive beliefs about AMR. These beliefs were influenced by knowledge, work setting, and country income. A proportion of respondents provided antibiotics without a prescription; the likelihood of this occurring was higher in those who held more negative beliefs about AMR.

ObjectivesThere is interest in doxycycline as prophylaxis against sexually transmitted infections (STIs), but concern about antimicrobial resistance (AMR). We conducted a systematic review (CRD42021273301) of the impact of oral tetracycline-class antibiotics on AMR in normal flora.MethodsWe searched MEDLINE, EMBASE, the Cochrane Library (1940–2021) and conference proceedings (2014–21) for randomized controlled trials in adults comparing daily oral tetracycline-class antibiotics to non-tetracycline controls. The primary outcome was AMR to tetracyclines; secondary outcomes included resistance to non-tetracyclines. Data were inappropriate for meta-analysis, so we analysed findings descriptively.ResultsOur search yielded 6265 abstracts of which 7 articles fulfilled inclusion criteria. Most were at moderate/high risk of bias, generally due to inadequate methodologic reporting. Studies used doxycycline, tetracycline, oxytetracycline or minocycline for 2–18 weeks. Most observed an increased burden of tetracycline resistance, including in subgingival (n = 3 studies), gastrointestinal (n = 2) and upper respiratory tract (n = 1) flora; one study of skin flora found no change in tetracycline-resistant Propionibacterium species after 18 weeks of oxytetracycline/minocycline. Four studies reassessed AMR at 2–50 weeks post-intervention and reported varying degrees of resistance. Three articles reported on the prevalence of non-tetracycline AMR after doxycycline prophylaxis, of which one found a transient increase among gastrointestinal Escherichia coli; the other two showed no difference from control.ConclusionsAlthough the effects are modest and transient, limited data from small prospective studies may suggest that oral tetracyclines for 2–18 weeks increase resistance in subgingival, gastrointestinal and upper respiratory tract flora. STI prophylaxis trials should include AMR in commensal bacteria as study outcomes.

BackgroundPrivate pharmacies are the first point of contact for the public regarding acquisition of medicines and other pharmaceuticals in many low- and middle-income countries including Uganda. Most antimicrobial stewardship (AMS) programmes in Uganda have targeted pharmacies in public health facilities, with little known about private pharmacies. This study explored knowledge and practices related to AMS in private pharmacies in Wakiso district, central Uganda.MethodsThis was a qualitative study that involved 31 in-depth interviews to explore AMS among retail private pharmacy staff including pharmacists, pharmacy technicians/dispensers, and nurses. Participants were asked about antimicrobial resistance (AMR) and AMS practices at their pharmacy. The audio-recorded interviews were transcribed verbatim and imported to NVivo 2020 (QSR International) for thematic analysis.ResultsFive major themes emerged from the study: commonly sold antimicrobials; knowledge on AMR and AMS; potential contributors to AMR; practices related to AMS; and challenges to AMS. The commonly sold antimicrobials in the pharmacies with or without prescriptions were oral azithromycin, Ampiclox® (ampicillin and cloxacillin), amoxicillin, ciprofloxacin, Septrin® (co-trimoxazole), metronidazole, Flucamox® (amoxicillin and flucloxacillin), Augmentin® (amoxicillin and clavulanic acid), cephalexin, doxycycline, and chloramphenicol. Participants had heard about AMR but not AMS, although only a few correctly defined AMR. Lack of knowledge among health workers and local communities; the overuse, misuse, and abuse of antimicrobials such as non-adherence to dosage; self-medication; and purchase of drugs without prescription were identified as potential accelerators to the emergence of AMR. Current practices related to AMS in private pharmacies were limited to meetings, antimicrobial dispensing, providing client advice, record keeping, and monitoring of drugs. Cost of healthcare, client satisfaction and retention, outdated guidelines, and the business orientation of pharmacies were the main challenges related to AMS.ConclusionThere was poor knowledge of AMR and AMS, and limited AMS practices in private pharmacies. Private pharmacies have the potential to contribute to Uganda’s fight against AMR if motivated and equipped with adequate knowledge to enhance their practices related to AMS.