The role of qualitative research in antibiotic stewardship programs

<p>Krushna Chandra Sahoo</p>

The role of qualitative research in antibiotic stewardship programs

Krushna Chandra Sahoo

Indian Council of Medical Research, India

: Med Microbiol Rep

Abstract

Antibiotic resistant is one of the major global health concerns. Injudicious and indiscriminate use of antibiotics in human and non-humans are the key reasons for resistance development; however, which varies from one context to another. To understand the contextual factors is the foremost step to design effective behavioural interventions, and the tailoring of interventions is best informed by qualitative research to ensure acceptability and feasibility of the socio-behavioral interventions. The study shows that there are three major factors which influence resistance – patients, health systems and professionals, and policy and regulatory issues. The patients' noncompliance with prescribers' instructions, selfmedication, poverty and lack of awareness on resistance were possible contributors for resistance development. The patients’ perception on antibiotics varied according to their education and urbanization; the educated informants were more familiar with the term antibiotics. The lack of infrastructure, improper diagnosis inadequate prescription was the major health system and professional factors for improper use of antibiotics. In remote areas due to lack of trained prescribers the untrained prescribers are irrationally prescribe antibiotics. Furthermore, weak implementation of prevailing legislation governing the healthcare system was another contributors to resistance development; because of weak drug policy counterfeit and over-the-counter antibiotics are available in market. The overall findings indicate that reducing the use of antibiotics could prevent resistance development; which will promote a better understanding of prescribers’ perception on factors influencing antibiotic prescribing and clarify how such factors could be minimized in decision-making process. The above qualitative findings are highlighting their importance in design and implementation of effective antibiotic stewardship programs.