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Table 1 Domains, themes, and representative quotes for outpatients seeking care for acute respiratory tract infections (ARTIs) at a tertiary care hospital in southern Sri Lanka

From: Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians

Domains

Themes

Representative quotes

Health-seeking behavior

Public sector preferred for ARTI care

“We don’t have money to take medicine from outside, so whatever the illness we get, we come here….”- OPD024

“No special reason, but there are good doctors in government hospitals. We believe that unnecessary drugs are not given from hospitals. When we are taking from dispensaries (private pharmacies), they give unnecessary drugs.”- OPD042

Multiple medical visits for ARTIs

“Today my wife has a clinic for a wound in the leg. Came for that, so took medicine at the same time.”- OPD021

“Took [medications for daughter] from the village…. It was a bit better, but as I came to take medicine, at the same time I took medicine for her from here as well.”- OPD027

Knowledge of ARTIs

Non-microbial etiology for ARTIs

[ARTIs are] due to heavy rain. N_ is full of mountains, so it is cold there. Other thing is eating foods in the fridge, that also causes wheezing”- OPD026

[ARTIs are] due to dust in the surroundings. There are lots of vehicles these days, so usually when I come I cover my nose. I get this illness even when I am exposed to a small amount of dust”- OPD039

“He eats ice cream all the time, he is always playing in the water, because of those reasons”- OPD061

Medications are needed to treat ARTIs

“No I will not accept it [if medications are not prescribed]. A mother is taking a child to the hospital as there is a difficulty due to the child’s illness. The mother knows the difficulty of the child, whatever the hospital says. So I will not be satisfied. Usually I bring the child here when the disease is severe…. Then I will go to the private sector”- OPD037

“Cannot accept [if medications are not prescribed]. Yesterday night I feel like dying due to severe cough…. Then I will come back another day and take”- OPD047

“Then we are disappointed… I will go to T_ Hospital. If I have money, I will go to the private sector. Then I don’t have to wait in the queue as well, it saves time. But we need money for that. Most of the time as we do not have money, we go to government hospitals.”- OPD031

Low level of knowledge regarding antibiotics

“When taking it, disease severity reduces. Also given to cure the wounds”- OPD036

“I thought that it is given for phlegm?”- OPD056

Treatment received during visit

Receipt of multiple prescriptions is common

“Although I came late, there was a nurse that I know, so could get the medications soon [from the OPD]. I can be satisfied as I also got a lot of medications”- OPD031

Patients were satisfied with care received

“Yes [I am satisfied]…. Now I have received medications. I will go home and take these. Hope that I will be well.”- OPD024

“Yes [I am satisfied]…. When we take these drugs properly, the illness cures in two days. Our fault is that we do not care of ourselves. When the illness gets better in one day with medications, we bathe, eat whatever we want, that way we make it worse.”- OPD025