Research Topic

Optimising Antibiotic Use: Social and Contextual Issues

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Modern medicine depends utterly on effective antimicrobials for the treatment and prevention of bacterial infections, but all antimicrobial use drives the emergence and spread of resistance. The rise in multidrug resistant organisms globally, and the increasing numbers of pan-resistant infections being ...

Modern medicine depends utterly on effective antimicrobials for the treatment and prevention of bacterial infections, but all antimicrobial use drives the emergence and spread of resistance. The rise in multidrug resistant organisms globally, and the increasing numbers of pan-resistant infections being identified, mean that antimicrobial resistance (AMR) is now a pressing global concern. Optimising the use of antibiotics has been identified as important for slowing the growth and spread of resistance. Approaches to optimising antibiotic use have primarily focused either on micro-level issues such as individual prescribing behaviour and individual behaviour change, or macro-level issues such as policy, regulation, and global coordination. In contrast, meso-level issues, including the role of communities and the social and organisational context in which antibiotic use takes place, require more attention. Prescribing behaviour in itself is not purely individual, but is socially and contextually embedded - shaped by identities, attitudes, social norms, hierarchy, local culture and systems, and ‘prescribing etiquette’. Antibiotic use more broadly can be understood as a complex phenomenon, involving a range of stakeholders acting within a complex system.

This Research Topic invites submissions that consider how antibiotic use is shaped by social context and the norms and practices of actors within communities. We would also be interested in papers that explore the application of social theories and methods to addressing the problem of AMR and optimising antibiotic use. We welcome researchers from diverse fields, including sociology, social psychology, clinical microbiology, economics, political science and public health. We invite submissions that address the following themes:

- Going beyond a focus on the prescriber: characterising communities of stakeholders and their roles along pathways of antibiotic use
- Using new methods to model the behaviours of communities of antibiotic prescribers or users
- Exploring social norms and collective understandings of antibiotic over-use: e.g. exploring the meanings of concepts related to antibiotics, antibiotic overuse, and ‘optimising’ antibiotic use, and how these are socially constructed
- Studying antibiotic use and AMR as a problem of large-scale collective action rather than individual behaviour change: e.g. research that addresses tensions between individual and collective interests, or explores how collective action to protect antibiotics could be promoted
- Using social science theory to design interventions that go beyond individual behaviour change: e.g. approaches to intervention development and implementation evaluation that focus on the wider context of antimicrobial stewardship

Papers that focus on low and middle-income countries, and papers that cut across traditional boundaries (e.g. human and animal health) would be particularly welcome.


Keywords: antibiotic prescribing, social theory, context, collective action, antimicrobial resistance


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