Antibiotic use, resistance development and environmental factors: a qualitative study among healthcare professionals in Orissa, India
Open Access
- 21 October 2010
- journal article
- Published by Springer Science and Business Media LLC in BMC Public Health
- Vol. 10 (1), 629-10
- https://doi.org/10.1186/1471-2458-10-629
Abstract
Background Antibiotic resistance is a major public health problem affecting both current and future generations. The influence of environmental factors on antibiotic use and resistance development in bacteria is largely unknown. This study explored the perceptions of healthcare providers on antibiotic use and resistance development in relation to environmental factors i.e. physical, natural, social and behavioural factors. Methods A qualitative interview study was conducted using face-to-face, semi-structured interviews among registered allopathic doctors, veterinarians and drug dispensers in Orissa, India. The interview transcripts were analyzed using latent content analysis. Results The main findings of this study relate to two themes: 'Interrelationship between antibiotic use, resistance development and environment' and 'Antibiotic management contributing to the development and spread of resistance'. The interviewees viewed the following as possible contributors to antibiotic use/misuse and resistance development: changes in the natural and physical environment i.e. climate variability, pollution, physiography and population growth; the socioeconomic environment affecting health-seeking behaviour and noncompliance with medication; a lack of healthcare facilities and poor professional attitudes; and ineffective law enforcement regarding medicine dispensing and disposal. Conclusions Generally, the interviewees perceived that although behavioural and social environmental factors are major contributors to resistance development, changes in the physical and natural environment also influence development of antibiotic resistance. The respondents also perceived that there is a lack of information about, and poor awareness of, what constitutes prudent use of antibiotics. They suggested a need for information, education, dissemination and proper implementation and enforcement of legislation at all levels of the drug delivery and disposal system in order to improve antibiotic use and prevent pharmaceutical contamination of the environment.Keywords
This publication has 33 references indexed in Scilit:
- Antibiotics and antibiotic-resistant bacteria in waters associated with a hospital in Ujjain, IndiaBMC Public Health, 2010
- Antibiotic Resistance inStaphylococcus aureusand Coagulase Negative Staphylococci Isolated from Goats with Subclinical MastitisVeterinary Medicine International, 2010
- Availability of Antibiotics for Purchase Without a Prescription on the InternetAnnals of Family Medicine, 2009
- Prevalence of Antibiotic Resistance in Drinking Water Treatment and Distribution SystemsApplied and Environmental Microbiology, 2009
- Spurious and counterfeit drugs: a growing industry in the developing worldPublished by Oxford University Press (OUP) ,2009
- Socioeconomic factors and antibiotic use in relation to antimicrobial resistance in the Amazonian area of PeruScandinavian Journal of Infectious Diseases, 2009
- Antibiotic prescribing practices in primary and secondary health care facilities in Uttar Pradesh, IndiaJournal of Clinical Pharmacy & Therapeutics, 2008
- The antibiotic resistome: the nexus of chemical and genetic diversityNature Reviews Microbiology, 2007
- Effect of social and climatological factors on antimicrobial use and Streptococcus pneumoniae resistance in different provinces in SpainJournal of Antimicrobial Chemotherapy, 2004
- PRESENCE OF DIHYDROSTREPTOMYCIN AND PENICILLIN IN COWS' MILK FOLLOWING INTRAUTERINE ADMINISTRATIONAustralian Veterinary Journal, 1982