TY - JOUR
T1 - Antibiotics in the community during the COVID-19 pandemic
T2 - A qualitative study to understand users' perspectives of antibiotic seeking and consumption behaviors in Bangladesh
AU - Abul Kalam, Md
AU - Shano, Shahanaj
AU - Afrose, Sharmin
AU - Uddin, Md Nasir
AU - Rahman, Nafis
AU - Jalal, Faruk Ahmed
AU - Akter, Samira
AU - Islam, Ariful
AU - Anam, Md Mujibul
AU - Hassan, Mohammad Mahmudul
PY - 2022/1/28
Y1 - 2022/1/28
N2 - Introduction: The COVID-19 pandemic is thought to have led to increased “inappropriate” or “unjustified” seeking and consumption of antibiotics by individuals in the community. However, little reference has been made to antibiotic seeking and using behaviors from the perspectives of users in Bangladesh during this health crisis. Purpose: This study seeks to document how antibiotic medicines are sought and used during a complex health crisis, and, within different contexts, what are the nuanced reasons why patients may utilize these medicines sub-optimally. Methods: We used an exploratory, qualitative design. Forty semi-structured telephone interviews were conducted with people diagnosed with COVID-19 (n=20), who had symptoms suggestive of COVID-19 (n=20), and who had received care at home in two cities between May and June 2021 in Bangladesh. In this study, an inductive thematic analysis was performed. Results: The analysis highlighted the interlinked relationships of antibiotic seeking and consumption behaviors with the diversity of information disseminated during a health crisis. Antibiotic-seeking behaviors are related to previous experience of use, perceived severity of illness, perceived vulnerability, risk of infection, management of an “unknown” illness and anxiety, distrust of expert advice, and intrinsic agency on antimicrobial resistance (AMR). Suboptimal adherence, such as modifying treatment regimes and using medication prescribed for others, were found to be part of care strategies used when proven therapeutics were unavailable to treat COVID-19. Early cessation of therapy was found to be a rational practice to avoid side effects and unknown risks. Conclusion: Based on the results, we highly recommend the take up of a pandemic specific antimicrobial stewardship (AMS) program in the community. To deliver better outcomes of AMS, incorporating users’ perspectives could be a critical strategy. Therefore, a co-produced AMS intervention that is appropriate for a specific cultural context is an essential requirement to reduce the overuse of antibiotics during the COVID-19 pandemic and beyond
AB - Introduction: The COVID-19 pandemic is thought to have led to increased “inappropriate” or “unjustified” seeking and consumption of antibiotics by individuals in the community. However, little reference has been made to antibiotic seeking and using behaviors from the perspectives of users in Bangladesh during this health crisis. Purpose: This study seeks to document how antibiotic medicines are sought and used during a complex health crisis, and, within different contexts, what are the nuanced reasons why patients may utilize these medicines sub-optimally. Methods: We used an exploratory, qualitative design. Forty semi-structured telephone interviews were conducted with people diagnosed with COVID-19 (n=20), who had symptoms suggestive of COVID-19 (n=20), and who had received care at home in two cities between May and June 2021 in Bangladesh. In this study, an inductive thematic analysis was performed. Results: The analysis highlighted the interlinked relationships of antibiotic seeking and consumption behaviors with the diversity of information disseminated during a health crisis. Antibiotic-seeking behaviors are related to previous experience of use, perceived severity of illness, perceived vulnerability, risk of infection, management of an “unknown” illness and anxiety, distrust of expert advice, and intrinsic agency on antimicrobial resistance (AMR). Suboptimal adherence, such as modifying treatment regimes and using medication prescribed for others, were found to be part of care strategies used when proven therapeutics were unavailable to treat COVID-19. Early cessation of therapy was found to be a rational practice to avoid side effects and unknown risks. Conclusion: Based on the results, we highly recommend the take up of a pandemic specific antimicrobial stewardship (AMS) program in the community. To deliver better outcomes of AMS, incorporating users’ perspectives could be a critical strategy. Therefore, a co-produced AMS intervention that is appropriate for a specific cultural context is an essential requirement to reduce the overuse of antibiotics during the COVID-19 pandemic and beyond
KW - Bangladesh
KW - Covid-19
KW - Antimicrobial resistance
KW - Antimicrobial stewardships
KW - Community engagement
KW - Consumption behavior
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=woscharlessturt_pure&SrcAuth=WosAPI&KeyUT=WOS:000749277300001&DestLinkType=FullRecord&DestApp=WOS_CPL
UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85124337920&origin=inward
U2 - 10.2147/PPA.S345646
DO - 10.2147/PPA.S345646
M3 - Article
C2 - 35115769
SN - 1177-889X
VL - 16
SP - 217
EP - 233
JO - Patient Preference and Adherence
JF - Patient Preference and Adherence
ER -
