{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T22:32:47Z","timestamp":1776637967096,"version":"3.51.2"},"reference-count":50,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"unspecified","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Research Foundation of South Africa","award":["129365"],"award-info":[{"award-number":["129365"]}]},{"name":"National Research Foundation of South Africa","award":["138721"],"award-info":[{"award-number":["138721"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,9]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Inappropriate antibiotic use in (primary healthcare, PHC) settings fuels antimicrobial resistance (AMR), threatens patient safety and burdens healthcare systems. Patients\u2019 knowledge, attitudes, motivations and expectations play a crucial role in antibiotic use behaviour, especially in low-income and middle-income countries including South Africa. There is a need to ensure measures of antibiotic use, interventions and future guidance reflect cultural, community and demographic issues associated with patient views to reduce inappropriate use of antibiotics and associated AMR. The objective of this scoping review is to identify key themes surrounding knowledge, attitudes, motivations and expectations among patients and community members regarding antimicrobial use in PHC settings especially in low-income and middle-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This scoping review employs a comprehensive search strategy across multiple electronic databases, including OVID, Medline, PubMed and CINHAL, to identify studies addressing patients or community members seeking care at PHC facilities and exploring key drivers of antimicrobial use. The Covidence web-based platform will be used for literature screening and data extraction and the Critical Appraisal Skills Programme qualitative checklist will assess the quality of qualitative papers. Anticipated results will provide an overview of the current evidence base, enabling identification of knowledge gaps. A narrative synthesis of findings will summarise key themes and patterns in patients\u2019 knowledge, attitudes, motivations and expectations related to antibiotic use across studies while considering methodological diversity and limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval is not required for this scoping review. The findings of this scoping review will be disseminated through publication in a peer-reviewed journal, presentation at relevant conferences and workshops, and collaboration with policy-makers and healthcare stakeholders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-088769","type":"journal-article","created":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T20:50:27Z","timestamp":1738529427000},"page":"e088769","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Knowledge, attitudes, motivations and expectations regarding antimicrobial use among community members seeking care at the primary healthcare level: a scoping review protocol"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9534-2972","authenticated-orcid":false,"given":"Nishana","family":"Ramdas","sequence":"first","affiliation":[{"name":"Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna C","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa"},{"name":"Sefako Makgatho Health Sciences University, Pretoria, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Schellack","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of Pretoria Faculty of Health Sciences, Pretoria, Gauteng, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Godman","sequence":"additional","affiliation":[{"name":"Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa"},{"name":"University of Strathclyde, Glasgow, UK"},{"name":"Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, City St. George\u2019s University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice Bolanle","family":"Turawa","sequence":"additional","affiliation":[{"name":"South African Medical Research Council, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa"},{"name":"The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,2]]},"reference":[{"key":"2025121514121572000_15.1.e088769.1","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/S0140-6736(22)00087-3","article-title":"The overlooked pandemic of antimicrobial resistance","volume":"399","author":"Laxminarayan","year":"2022","journal-title":"Lancet"},{"key":"2025121514121572000_15.1.e088769.2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S234610"},{"key":"2025121514121572000_15.1.e088769.3","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-018-0125-x"},{"key":"2025121514121572000_15.1.e088769.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0\/ATTACHMENT\/4504FC2B-08AE-46D6-BD75-80811DF8B5E6\/MMC1.PDF"},{"key":"2025121514121572000_15.1.e088769.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30605-4"},{"key":"2025121514121572000_15.1.e088769.6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.31729\/jnma.7174","article-title":"Antimicrobial Resistance: The Next Probable Pandemic","volume":"60","author":"Gautam","year":"2022","journal-title":"JNMA J Nepal Med Assoc"},{"key":"2025121514121572000_15.1.e088769.7","first-page":"10","article-title":"A Narrative Review of Antibiotic Prescribing Practices in Primary Care Settings in South Africa and Potential Ways Forward to Reduce Antimicrobial Resistance","volume":"12","author":"Chigome","year":"2023","journal-title":"Antibiotics (Basel)"},{"key":"2025121514121572000_15.1.e088769.8","first-page":"12","article-title":"Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future","volume":"11","author":"Saleem","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"2025121514121572000_15.1.e088769.9","doi-asserted-by":"crossref","DOI":"10.1093\/jacamr\/dlab196","article-title":"Using mystery shoppers to determine practices pertaining to antibiotic dispensing without a prescription among community pharmacies in South Africa-a pilot survey","volume":"4","author":"Mokwele","year":"2022","journal-title":"JAC Antimicrob Resist"},{"key":"2025121514121572000_15.1.e088769.10","doi-asserted-by":"crossref","DOI":"10.1186\/s13690-020-00517-9","article-title":"The use of non-prescribed antibiotics; 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