Social determinants of antibiotic misuse: a qualitative study of community members in Haryana, India. BMC Public Health 2017 Apr 19;17(1):333
Date
04/20/2017Pubmed ID
28420365Pubmed Central ID
PMC5395834DOI
10.1186/s12889-017-4261-4Scopus ID
2-s2.0-85018510755 (requires institutional sign-in at Scopus site) 87 CitationsAbstract
BACKGROUND: Antibiotic resistance is a global public health crisis. In India alone, multi-drug resistant organisms are responsible for over 58,000 infant deaths each year. A major driver of drug resistance is antibiotic misuse, which is a pervasive phenomenon worldwide. Due to a shortage of trained doctors, access to licensed allopathic doctors is limited in India's villages. Pharmacists and unlicensed medical providers are commonly the primary sources of healthcare. Patients themselves are also key participants in the decision to treat an illness with antibiotics. Thus, better understanding of the patient-provider interactions that may contribute to patients' inappropriate use of antibiotics is critical to reducing these practices in urban and rural Indian villages.
METHODS: We conducted a qualitative study of the social determinants of antibiotic use among twenty community members in Haryana, India. Semi-structured interview questions focused on two domains: typical antibiotic use and the motivation behind these practices. A cross-sectional pilot survey investigated the same twenty participants' understanding and usage of antibiotics. Interview and open-ended survey responses were translated, transcribed, and coded for themes.
RESULTS: Antibiotics and the implications of their misuse were poorly understood by study participants. No participant was able to correctly define the term antibiotics. Participants with limited access to an allopathic doctor, either for logistic or economic reasons, were more likely to purchase medications directly from a pharmacy without a prescription. Low income participants were also more likely to prematurely stop antibiotics after symptoms subsided. Regardless of income, participants were more likely to seek an allopathic doctor for their children than for themselves.
CONCLUSIONS: The prevalent misuse of antibiotics among these community members reinforces the importance of conducting research to develop effective strategies for stemming the tide of antibiotic resistance in India's villages.
Author List
Barker AK, Brown K, Ahsan M, Sengupta S, Safdar NAuthor
Kelli Brown DrPH Assistant Professor in the Institute for Health and Humanity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAnti-Bacterial Agents
Drug Resistance, Microbial
Female
Humans
India
Male
Motivation
Prescription Drug Misuse
Qualitative Research
Rural Population
Socioeconomic Factors
Surveys and Questionnaires
Urban Population
