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"Without antibiotics, I cannot treat": A qualitative study of antibiotic use in Paschim Bardhaman district of West Bengal, India.
Nair, Mohit; Tripathi, Santanu; Mazumdar, Sumit; Mahajan, Raman; Harshana, Amit; Pereira, Alan; Jimenez, Carolina; Halder, Debasish; Burza, Sakib.
Afiliación
  • Nair M; Medecins Sans Frontieres, New Delhi, India.
  • Tripathi S; Calcutta School of Tropical Medicine, Kolkata, India.
  • Mazumdar S; Centre for Health Economics, University of York, York, United Kingdom.
  • Mahajan R; Medecins Sans Frontieres, New Delhi, India.
  • Harshana A; Medecins Sans Frontieres, New Delhi, India.
  • Pereira A; Medecins Sans Frontieres, New Delhi, India.
  • Jimenez C; Medecins Sans Frontieres, Barcelona, Spain.
  • Halder D; Paschim Bardhaman Health District, West Bengal, India.
  • Burza S; Medecins Sans Frontieres, New Delhi, India.
PLoS One ; 14(6): e0219002, 2019.
Article en En | MEDLINE | ID: mdl-31247028
BACKGROUND: Misuse of antibiotics is a well-known driver of antibiotic resistance. Given the decentralized model of the Indian health system and the shortage of allopathic doctors in rural areas, a wide variety of healthcare providers cater to the needs of patients in urban and rural settings. This qualitative study explores the drivers of antibiotic use among formal and informal healthcare providers as well as patients accessing care at primary health centers across Paschim Bardhaman district in West Bengal. MATERIALS AND METHODS: We conducted 28 semi-structured, in-depth interviews with four groups of healthcare providers (allopathic doctors, informal health providers, nurses, and pharmacy shopkeepers) as well as patients accessing care at primary health centers and hospitals across Paschim Bardhaman district. Qualitative data was analyzed using the framework method in an inductive and deductive manner. RESULTS: Our results indicate that patients demand antibiotics from healthcare providers and seek the fastest cure possible, which influences the prescription choices of healthcare providers, particularly informal health providers. Many allopathic doctors provide antibiotics without any clinical indication due to inconsistent follow up, lack of testing facilities, risk of secondary infections, and unhygienic living conditions. Pharmaceutical company representatives actively network with informal health providers and formal healthcare providers alike, and regularly visit providers even in remote areas to market newer antibiotics. Allopathic doctors and informal health providers frequently blame the other party for being responsible for antibiotic resistance, and yet both display interdependence in referring patients to one another. CONCLUSIONS: A holistic approach to curbing antibiotic resistance in West Bengal and other parts of India should focus on strengthening the capacity of the existing public health system to deliver on its promises, improving patient education and counseling, and including informal providers and pharmaceutical company representatives in community-level antibiotic stewardship efforts.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Programas de Optimización del Uso de los Antimicrobianos / Antibacterianos Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Humans País/Región como asunto: Asia Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Programas de Optimización del Uso de los Antimicrobianos / Antibacterianos Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Humans País/Región como asunto: Asia Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos