Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

Abstract

Background Antibiotic resistance is a complex phenomenon heavily influenced by social, cultural, behavioural, and economic factors that lead to the misuse, overuse and abuse of antibiotics. Recent research has highlighted the role that norms and values can play for behaviours that contribute to resistance development, and for addressing such behaviours. Despite comparatively high antibiotic consumption in Greece, both at the community and healthcare level, Greeks have been shown to be relatively aware of the connection between antibiotic overuse and antibiotic resistance. This suggests that Greeks’ non-judicious use cannot simply be explained by lack of awareness but may relate to other factors specific to Greek society. The present study aimed to explore attitudes, perceived norms, and values in relation to antibiotics, in order to improve understanding of socio-cultural determinants of antibiotic resistance in Greece. Methods Data were collected through online focus group discussions in 2021. Twenty Greeks were recruited through purposive sampling, aiming for as heterogeneous groups as possible regarding gender (12 women, 8 men), age (range 21–55, mean 33), and education level. Interview transcripts were analysed inductively using thematic content analysis. Results Participants considered antibiotic overconsumption as a consolidated habit influenced by ease of access, social expectations and, more generally, cultural practices. While critical of such norms and practices, participants opposed stewardship measures that would prioritize the societal interest in maintaining antibiotic effectiveness over individual needs. Participants considered responsibility for antibiotic resistance to be shared by the whole society, but the role of government actors and health professionals as well as of food producers was emphasized. Notably, scepticism about the prospect of effectively managing antibiotic resistance in Greece was commonly expressed. Conclusions The study makes explicit attitudes, perceived norms and values that, besides limited awareness, may contribute to non-judicious antibiotic use in Greece. These socio-cultural determinants of antibiotic resistance warrant further research and should be considered when designing measures aimed to mitigate this problem.

A Cross-Sectional Study About Factors Contributing to Use of Antibiotics Among Residents of Moroto Parish in Palabek Gem Subcounty, Aged From 18- 65 Years in Lamwo District (Uganda).

“…When assessed on their ideas on whether one can buy Abs from clinics without doctors' prescription, 12 (24.0%) respondents agreed, 18 (36.0%) strongly agreed, 13 (26.0%) of them disagreed and 7 (14.0%) respondents strongly disagreed. This finding means that majority of the respondents could obtain Abs with ease without prescriptions which agreed with the result of a study conducted (Papadimou, Malmqvist, & Ancillotti, 2022) in Greece where respondents reported easy access to Abs even without prescription.…”

Antimicrobial resistance research in Singapore – mapping current trends and future perspectives

“…Although culturally dissimilar, the similarities with a recent study on AMR knowledge and awareness among Singaporeans [22] demonstrated the need to improve AMR education. In addition to studies in Japan, China and Singapore, results regarding AMR knowledge in Ethiopia, Italy and Greece also showed that education with more appropriate content remained a requirement, and that this was not restricted to a single population or country [12, 23, 24]. Reviews on the contribution of AMR and the consequences for the population, such as that published by Verraes et al, provide updated information to the scientific community working on AMR in the food sector [25].…”

Prosocial Behaviour and Antibiotic Resistance: Evidence from a Discrete Choice Experiment

“…Trust as a determinant of AR has been linked, in previous Swedish studies, with willingness to contribute to antibiotic stewardship, for instance, by postponing antibiotic treatment and accepting doctors’ decisions not to prescribe antibiotics [ 21 , 55 ]. Conversely, a lack of trust was regarded as a hindering factor for engaging in judicious antibiotic behaviour [ 56 , 57 ]. Supposedly, there is a connection between trust and prosociality because trust involves positive expectations for others’ behaviour [ 58 ].…”