Sociocultural perspectives on antibiotic consumption and resistance

In 2015, the World Health Organization cited antibiotic resistance as one of the greatest current challenges to global public health. A major driver of the evolution of antibiotic resistance is the overuse and misuse of these drugs. While antibiotic stewardship, education campaigns, and health policy attempt to limit drug use globally, public understanding of antibiotic resistance and its consequences are lacking. The goal of this study is to analyze the social and cultural influences of antibiotic knowledge and usage behavior. Over a three-month period, I interviewed 211 laypersons in Guatemala, Spain, the Netherlands, India, South Africa, and New Zealand to understand their ideas, perceptions, and behaviors regarding antibiotics and compared results across countries. While an overall consensus across countries does exist, I found significant differences between low and high income countries as well as between low and high antibiotic consumption countries. Additionally, I found that having increased public health knowledge is related to lower antibiotic "risky" behavior. 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.