Access, excess, and ethics—towards a sustainable distribution model for antibiotics
2014 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 119, no 2, 134-141 p.Article, review/survey (Refereed) Published
The increasing antibiotic resistance is a global threat to health care as we know it. Yet there is no model of distribution ready for a new antibiotic that balances access against excessive or inappropriate use in rural settings in low-and middle-income countries (LMICs) where the burden of communicable diseases is high and access to quality health care is low. Departing from a hypothetical scenario of rising antibiotic resistance among pneumococci, 11 stakeholders in the health systems of various LMICs were interviewed one-on-one to give their view on how a new effective antibiotic should be distributed to balance access against the risk of inappropriate use. Transcripts were subjected to qualitative 'framework' analysis. The analysis resulted in four main themes: Barriers to rational access to antibiotics; balancing access and excess; learning from other communicable diseases; and a system-wide intervention. The tension between access to antibiotics and rational use stems from shortcomings found in the health systems of LMICs. Constructing a sustainable yet accessible model of antibiotic distribution for LMICs is a task of health system-wide proportions, which is why we strongly suggest using systems thinking in future research on this issue.
Place, publisher, year, edition, pages
2014. Vol. 119, no 2, 134-141 p.
Antibiotic distribution, antibiotic resistance, ethics, rational use, systems thinking
IdentifiersURN: urn:nbn:se:uu:diva-223161DOI: 10.3109/03009734.2014.904958ISI: 000336526100011OAI: oai:DiVA.org:uu-223161DiVA: diva2:712779