SOCIAL AND CULTURAL INFLUENCES OF ANTIBIOTIC CONSUMPTION AND RESISTANCE

Antibiotic resistance is the ability of bacteria to grow in the presence of a drug that would normally inhibit them. WHO has highlighted antibiotic resistance as one of the greatest current challenges to global public health. While resistance occurs naturally as bacteria evolve, overuse and misuse of antibiotics is accelerating this process. The principal aim of this study is to analyze the role of sociocultural influences on antibiotic consumption and resistance. The project focuses on how antibiotic public health knowledge and views of prescription practices influence consumption. It is known that there are large knowledge gaps across the globe regarding antibiotic resistance emergence and how overconsumption accelerates this process.This study aims to uncover cultural factors for these knowledge gaps. The ultimate goal in assessing sociocultural ties to public health knowledge of resistance and consumption is to reveal possibilities of new educational initiatives, awareness campaigns and policies. To be successful, these interventions must be culturally relevant to intended audiences. The study was conducted in countries with low (Guatemala/the Netherlands), intermediate (India/Spain) and high (South Africa/New Zealand) antibiotic consumption rates. In each site, an opportunity sample was used to recruit participants in a survey to assess knowledge, cultural views and personal consumption. Recruitment occurred in public spaces such as parks, markets and malls. Survey data was analyzed using the Cultural Consensus Analysis which measures patterns of agreement and variation amongst participants to determine the extent of shared beliefs regarding antibiotics. This method allows us to examine whether individuals within and across international contexts share similar cultural models regarding antibiotic use and perceptions of resistance as well as to test for specific factors that influence this agreement, such as country GDP, ethnicity, religion, gender, and access to medical care. Additionally, semi-structured interviews were conducted with pharmacists in each country which highlight the different perspectives on antibiotic consumption and resistance among health professionals in different contexts. These results help contextualize national data on antibiotic consumption and resistance by illustrating relationships between access, beliefs and consumption patterns within populations. The results also inform the development of community and culture specific educational campaigns regarding antibiotic resistance.