A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India
<b>Background:</b> It is well established by research that large-scale and indiscriminate prescribing, dispensing, and use of antimicrobials drive antimicrobial resistance (AMR) endangering the health and well-being of people, animals, and the environment. In the context of low- and midd...
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MDPI AG
2025-02-01
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| Series: | Antibiotics |
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| author | Rashmi Surial Sundeep Sahay Vinay Modgil Arunima Mukherjee Ritika Kondal Bhandari |
| author_facet | Rashmi Surial Sundeep Sahay Vinay Modgil Arunima Mukherjee Ritika Kondal Bhandari |
| author_sort | Rashmi Surial |
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| description | <b>Background:</b> It is well established by research that large-scale and indiscriminate prescribing, dispensing, and use of antimicrobials drive antimicrobial resistance (AMR) endangering the health and well-being of people, animals, and the environment. In the context of low- and middle-income countries (LMICs), the prescribing of antimicrobials is often not based on biomedical rationality but involves alternative logic driven by social, cultural, and institutional factors. This paper seeks to develop a “biosocial” perspective, reflecting a unified perspective that treats the biomedical and social conditions as two sides of the same coin. <b>Methods:</b> This analysis is based on an empirical investigation of prescription slips that patients carry to buy drugs from the pharmacy following an outpatient department encounter with the clinician. Data collection involves mixed methods, including the quantitative analysis of the antimicrobials prescribed and a qualitative analysis of the underlying reasons for these prescriptions, as described by doctors, pharmacists, and patients. Data analysis involved triangulating quantitative and qualitative data, to develop a “biosocial” perspective, which can provide implications for the development of antimicrobial stewardship policies, particularly relevant for health institutions in low- and middle-income countries. <b>Results:</b> Our analysis of 1175 prescription slips showed that 98% contained antimicrobials, with 74% being broad-spectrum antimicrobials. Only 9% of cases were advised antimicrobial sensitivity testing (AST) before initiating treatment. Qualitative findings indicated that patients had poor awareness of antimicrobials and pharmacists played a crucial role in counseling. <b>Conclusions:</b> This study highlights that antimicrobial prescriptions in public health settings are influenced by both biomedical and social factors, supporting a biosocial perspective. Although AMS interventions are predominantly biomedical, adhering to clinical standards and best practices, this study underscores the necessity of integrating a biosocial viewpoint by incorporating the experiences of pharmacists and patient groups. Strengthening diagnostic support, patient education, and interprofessional collaboration could improve rational antimicrobial uses in low-resource settings. |
| format | Article |
| id | doaj-art-a290e5881c3a4c0c8a089cf4583ff69c |
| institution | Kabale University |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj-art-a290e5881c3a4c0c8a089cf4583ff69c2025-08-20T03:43:50ZengMDPI AGAntibiotics2079-63822025-02-0114321310.3390/antibiotics14030213A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North IndiaRashmi Surial0Sundeep Sahay1Vinay Modgil2Arunima Mukherjee3Ritika Kondal Bhandari4Society for Health Information Systems Programmes (HISP India), New Delhi 110025, IndiaSociety for Health Information Systems Programmes (HISP India), New Delhi 110025, IndiaSociety for Health Information Systems Programmes (HISP India), New Delhi 110025, IndiaSociety for Health Information Systems Programmes (HISP India), New Delhi 110025, IndiaDepartment of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India<b>Background:</b> It is well established by research that large-scale and indiscriminate prescribing, dispensing, and use of antimicrobials drive antimicrobial resistance (AMR) endangering the health and well-being of people, animals, and the environment. In the context of low- and middle-income countries (LMICs), the prescribing of antimicrobials is often not based on biomedical rationality but involves alternative logic driven by social, cultural, and institutional factors. This paper seeks to develop a “biosocial” perspective, reflecting a unified perspective that treats the biomedical and social conditions as two sides of the same coin. <b>Methods:</b> This analysis is based on an empirical investigation of prescription slips that patients carry to buy drugs from the pharmacy following an outpatient department encounter with the clinician. Data collection involves mixed methods, including the quantitative analysis of the antimicrobials prescribed and a qualitative analysis of the underlying reasons for these prescriptions, as described by doctors, pharmacists, and patients. Data analysis involved triangulating quantitative and qualitative data, to develop a “biosocial” perspective, which can provide implications for the development of antimicrobial stewardship policies, particularly relevant for health institutions in low- and middle-income countries. <b>Results:</b> Our analysis of 1175 prescription slips showed that 98% contained antimicrobials, with 74% being broad-spectrum antimicrobials. Only 9% of cases were advised antimicrobial sensitivity testing (AST) before initiating treatment. Qualitative findings indicated that patients had poor awareness of antimicrobials and pharmacists played a crucial role in counseling. <b>Conclusions:</b> This study highlights that antimicrobial prescriptions in public health settings are influenced by both biomedical and social factors, supporting a biosocial perspective. Although AMS interventions are predominantly biomedical, adhering to clinical standards and best practices, this study underscores the necessity of integrating a biosocial viewpoint by incorporating the experiences of pharmacists and patient groups. Strengthening diagnostic support, patient education, and interprofessional collaboration could improve rational antimicrobial uses in low-resource settings.https://www.mdpi.com/2079-6382/14/3/213antimicrobial resistanceprescription practicesdrug qualityantimicrobial prescriptionculture sensitivity testingbranded antimicrobials |
| spellingShingle | Rashmi Surial Sundeep Sahay Vinay Modgil Arunima Mukherjee Ritika Kondal Bhandari A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India Antibiotics antimicrobial resistance prescription practices drug quality antimicrobial prescription culture sensitivity testing branded antimicrobials |
| title | A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India |
| title_full | A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India |
| title_fullStr | A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India |
| title_full_unstemmed | A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India |
| title_short | A Biosocial Perspective to Understand Antimicrobial Prescription Practices: A Retrospective Cross-Sectional Study from a Public Community Health Center in North India |
| title_sort | biosocial perspective to understand antimicrobial prescription practices a retrospective cross sectional study from a public community health center in north india |
| topic | antimicrobial resistance prescription practices drug quality antimicrobial prescription culture sensitivity testing branded antimicrobials |
| url | https://www.mdpi.com/2079-6382/14/3/213 |
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