Social and cultural determinants of antibiotics prescriptions: analysis from a public community health centre in North India

Abstract

This paper explores the socio cultural and institutional determinants of irresponsible prescription and use of antibiotics which has implications for the rise and spread of antimicrobial resistance (AMR). This study describes the patterns of prescription of antibiotics in a public facility in India and identifies the underlying institutional, cultural and social determinants driving the irresponsible use of antibiotics. The analysis is based on an empirical investigation of patients’ prescriptions that reach the in-house pharmacy following an outpatient department (OPD) encounter with the clinician. The prescription analysis describes the factors associated with use of broad-spectrum antibiotics, and a high percentage of prescriptions for dental outpatient department prescribed as a precautionary measure. This paper further highlights the need for future research insights in combining socio-cultural approach with medical rationalities, to further explore questions our analysis highlights like higher antibiotic prescription, etc., Along with the recommendations for further research.

Regional variations in antimicrobial susceptibility of community-acquired uropathogenic Escherichia coli in India: Findings of a multicentric study highlighting the importance of local antibiograms

“…Geographic variability underscores the need to generate and use local antibiograms to support appropriate empirical prescribing, exactly as DASH seeks to support [ 20 ]. The higher resistance in N India may be linked to several factors: greater over-the-counter sale of antibiotics, indiscriminate prescription of antibiotics, large population with low per capita income, higher burden of disease, and substandard drugs [ [33] , [34] , [35] ]. It also underscores the likely weakness of any global surveillance that only includes three or four centers to represent a country as large and diverse as India.…”