Table 2 Description of the identified themes

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All clinicians, microbiologists, pharmacists, and nosocomial infection management personnel conveyed a robust willingness to endorse the National Action Plan. Across all professions, pharmacists scored highest for different dimensions of attitude. (Fig. 3)

Attitudes

Individual factors

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Across all professions, pharmacists scored highest for self-learning. (Fig. 3)

Professional behavior

“As long as leaders pay attention, things can be done, whether it is antimicrobial stewardship or hospital associated infection control.” [nosocomial infection management personnel]

A lack of awareness among managers of the importance and strategies for curbing antimicrobial resistance will hinder the successful adoption and implementation of national action plans in health facilities.

Administrative support

Leadership

“To be honest, sometimes when we give advice to doctors, they don’t necessarily follow it.” [Pharmacist]

Hospital managers recognized that recruiting specialist staff was not enough, as these staff needed to work together as a team, and many clinicians interviewed further emphasized that structural disintegration would hinder effective team work by antimicrobial management teams.

Multidisciplinary collaboration

Professional collaboration

“Clinicians are more careful about the use of antimicrobial agents than surgeons, and I think we need more cooperation because clinicians need some guidance on how to interpret reports of sensitivity test.” [Microbiologist]

“Antimicrobial drugs are a double-edged sword, irrational use will lead to drug resistance, But the reality of the situation you face is always complicated.” [Clinician]

A significant concern for doctors revolves around the substantial pressure of responsibility.

Clinical experience

Patient factors

“Patients sometimes ask me to prescribe antibiotics, but if I communicate with them, they are very compliant with my prescriptions” [Clinician]

Respondents sometimes felt pressured to prescribe antibiotics, especially when they felt there was no need for patients or their relatives to use antibiotics.

Patient preferences

There always this kind of training, it is irregularly. It’s mainly clinical cases discussion. We are very busy. Our schedule is too full. [clinician]

Training is mainly irregularly and unsystematic and comes mainly from clinical cases discussion.

Irregularly and unsystematic

Training

When there is a will, there is a way. When patient is convinced that antimicrobial agents are working for them, they will find a way to get them, so it is important to teach correct knowledge. [clinician]

When patient get cold or even other disease, the first reaction is to take antimicrobial agents.

Antimicrobial agents use culture

Culture