The unseen use of antimicrobials: Drivers of human antibiotic use in a community in Thailand and implications for surveillance
Issued Date
2024-01-01
Resource Type
ISSN
17441692
eISSN
17441706
Scopus ID
2-s2.0-85181728005
Pubmed ID
38190612
Journal Title
Global Public Health
Volume
19
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Global Public Health Vol.19 No.1 (2024)
Suggested Citation
Alhusein N., Charoenboon N., Wichuwaranan K., Poonsawad K., Montrivade V., Avison M.B., Sringernyuang L., Lambert H. The unseen use of antimicrobials: Drivers of human antibiotic use in a community in Thailand and implications for surveillance. Global Public Health Vol.19 No.1 (2024). doi:10.1080/17441692.2023.2298940 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95525
Title
The unseen use of antimicrobials: Drivers of human antibiotic use in a community in Thailand and implications for surveillance
Author's Affiliation
Corresponding Author(s)
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Abstract
We investigated sociocultural and economic drivers of human antimicrobial use (AMU) in Thailand through ethnographic research, interviews, focus groups and a cross-sectional survey. This community-based study generated findings clustered around three key themes: treatment-seeking practices, medicine use, and interpretation of biomedical constructs. Participants sought care from public health facilities for chronic conditions, but medicines from the private sector were considered more powerful and were preferred for acute complaints. Many antibiotics were unrecognised as such by consumers due to the practice at private healthcare facilities of dispensing repackaged medicines without identifying labels. This unseen use of antibiotics is probably driven by economic drivers including market competition in the private sector, policy implementation drivers whereby rational drug use policies mainly target the public sector, behavioural drivers relating to treatment seeking-practices, and sociocultural drivers that influenced participants’ understanding of medical terms and concepts. Participants regarded antibiotics as reducing inflammation and were uncertain about the distinctions between anti-inflammatories, antibiotics, and pain relievers. Antimicrobial Resistance (AMR) was understood as a form of drug tolerance to be remedied by changing the medicine. Community surveys may not provide accurate estimates of AMU where people are unable to distinguish antibiotics reliably from other medicines.