中低收入国家公众在没有处方的情况下使用抗生素的影响因素:系统回顾和定性证据综述。

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-10-25 eCollection Date: 2024-10-01 DOI:10.1093/jacamr/dlae165
Christie Cabral, Tingting Zhang, Isabel Oliver, Paul Little, Lucy Yardley, Helen Lambert
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引用次数: 0

摘要

目的:在许多低收入和中等收入国家(LMIC),使用抗生素自行用药是常见的做法。本综述综合了在低收入和中等收入国家中,公众使用抗生素自我用药的观念和做法所受影响的定性证据:方法:对相关的医学、国际和社会科学数据库进行了系统检索。搜索、筛选、数据提取和质量评估均遵循标准方法。采用元人种学方法进行综合,首先对研究进行翻译,然后采用论证方法确定最终主题:结果:搜索发现了 78 项符合条件的研究。抗生素被认为是治疗感染的强效、潜在危险但有效的药物。这种观念受到个人和集体被处方抗生素治疗感染的共同经历的强烈影响。这促使人们将抗生素理解为一种治疗感染症状的合理药物,并得到医疗机构的认可。从医疗专业人员那里获得抗生素往往在后勤和经济上都很困难。相比之下,抗生素在当地的非处方药店很容易买到。人们认为使用抗生素治疗感染症状是合理的做法,尽管他们担心抗生素对个人的风险,并且只在他们认为需要时才使用:结论:本文提出了一个解释抗生素自我用药的新模型。结论:本文提出了一种解释抗生素自我药疗的新模式,该模式采用社会生态模式,综合了个人、社区和更广泛的社会经济层面的影响因素,并借鉴了医疗权威和医疗化以及健康商业化的理论。在低收入和中等收入国家减少抗生素过度使用的干预措施需要同时解决临床实践和社区自我药疗实践两个方面的问题。
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Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence.

Objectives: Self-medication with antibiotics is common practice in many low- and middle-income countries (LMIC). This review synthesizes the qualitative evidence on influences on perceptions and practices in relation to self-medication by the public with antibiotics in LMIC.

Methods: A systematic search was conducted of relevant medical, international and social science databases. Searching, screening, data extraction and quality appraisal followed standard methods. A meta-ethnographic approach was used for synthesis, starting with translation of studies and using a line-of-argument approach to develop the final themes.

Results: The search identified 78 eligible studies. Antibiotics were understood as a powerful, potentially dangerous but effective medicine for treating infections. This perception was strongly influenced by the common experience of being prescribed antibiotics for infections, both individually and collectively. This contributed to an understanding of antibiotics as a rational treatment for infection symptoms that was sanctioned by medical authorities. Accessing antibiotics from medical professionals was often difficult logistically and financially. In contrast, antibiotics were readily available over the counter from local outlets. People viewed treating infection symptoms with antibiotics as rational practice, although they were concerned about the risks to the individual and only took them when they believed they were needed.

Conclusions: A new model to explain self-medication with antibiotics is presented. This uses the socio-ecological model to integrate influences that operate at individual, community and wider socioeconomic levels, drawing on theories of medical authority and the medicalization and commercialization of health. Interventions to reduce overuse of antibiotics in LMIC need to address both clinical practice and community self-medication practices together.

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CiteScore
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0.00%
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审稿时长
16 weeks
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