Antibiotic Economies: The Economisation of Antibiotic Use in Australia and Implications for the Mitigation of Antimicrobial Resistance.

Abstract

This paper examines how economic rationalities shape antibiotic usage with the aim of expanding options for the reduction of antimicrobial resistance (AMR). Antibiotic usage is typically attributed to the individual behaviours of patients, pet owners and prescribers, an emphasis that has neglected sociological explanations, particularly the economic rationalities that are transforming healthcare. We used sociological theory of pharmaceutical capitalisation and economisation to explore in-depth interviews on antibiotic usage with scientists, policymakers, prescribers, patients and pet owners in Australia. Antibiotics attracted values in terms of cost to the patient and pet owner, profit for the clinic, how the drugs saved time away from work and childcare, and how they eased the pressures of self-care, parenting and pet ownership. Economic transactions that are only partially under individual patient and prescriber control shape antibiotic use. In these circumstances, antibiotic use is influenced by other social agents-for example, business managers and clinic owners-decentring prescriber authority. Adoption of socio-economic values of antibiotic usage and inclusion of its other economic agents is needed to improve AMR intervention effectiveness.