Academic Journal

Drivers of inappropriate use of antimicrobials in South Asia: A systematic review of qualitative literature.

التفاصيل البيبلوغرافية
العنوان: Drivers of inappropriate use of antimicrobials in South Asia: A systematic review of qualitative literature.
المؤلفون: Jennifer L Murray, Daniel T Leung, Olivia R Hanson, Sharia M Ahmed, Andrew T Pavia, Ashraful I Khan, Julia E Szymczak, Valerie M Vaughn, Payal K Patel, Debashish Biswas, Melissa H Watt
المصدر: PLOS Global Public Health, Vol 4, Iss 4, p e0002507 (2024)
بيانات النشر: Public Library of Science (PLoS), 2024.
سنة النشر: 2024
المجموعة: LCC:Public aspects of medicine
مصطلحات موضوعية: Public aspects of medicine, RA1-1270
الوصف: Antimicrobial resistance is a global public health crisis. Effective antimicrobial stewardship requires an understanding of the factors and context that contribute to inappropriate use of antimicrobials. The goal of this qualitative systematic review was to synthesize themes across levels of the social ecological framework that drive inappropriate use of antimicrobials in South Asia. In September 2023, we conducted a systematic search using the electronic databases PubMed and Embase. Search terms, identified a priori, were related to research methods, topic, and geographic location. We identified 165 articles from the initial search and 8 upon reference review (n = 173); after removing duplicates and preprints (n = 12) and excluding those that did not meet eligibility criteria (n = 115), 46 articles were included in the review. We assessed methodological quality using the qualitative Critical Appraisal Skills Program checklist. The studies represented 6 countries in South Asia, and included data from patients, health care providers, community members, and policy makers. For each manuscript, we wrote a summary memo to extract the factors that impede antimicrobial stewardship. We coded memos using NVivo software; codes were organized by levels of the social ecological framework. Barriers were identified at multiple levels including the patient (self-treatment with antimicrobials; perceived value of antimicrobials), the provider (antimicrobials as a universal therapy; gaps in knowledge and skills; financial or reputational incentives), the clinical setting (lack of resources; poor regulation of the facility), the community (access to formal health care; informal drug vendors; social norms), and policy (absence of a regulatory framework; poor implementation of existing policies). This study is the first to succinctly identify a range of norms, behaviors, and policy contexts driving inappropriate use of antimicrobials in South Asia, emphasizing the importance of working across multiple sectors to design and implement approaches specific to the region.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2767-3375
Relation: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002507&type=printable; https://doaj.org/toc/2767-3375
DOI: 10.1371/journal.pgph.0002507&type=printable
DOI: 10.1371/journal.pgph.0002507
URL الوصول: https://doaj.org/article/5c03bacf84624a5c9e17cad1a03c4156
رقم الانضمام: edsdoj.5c03bacf84624a5c9e17cad1a03c4156
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:27673375
DOI:10.1371/journal.pgph.0002507&type=printable