ArticlePloS one2019
"Without antibiotics, I cannot treat": A qualitative study of antibiotic use in Paschim Bardhaman district of West Bengal, India.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Behavioural interventions to address rational use of antibiotics in outpatient settings of low-income and lower-middle-income countries.Tropical medicine & international health : TM & IH · 2021Pooled it
- Antibiotic dispensing practices and determinants among informal healthcare providers in low- and middle-income countries: a mixed-methods scoping review.BMJ global health · 2026Article
- Perspectives and Challenges of Healthcare Professionals, Patients, and Caregivers Regarding Utilizing Antibiotics and Implementing Antibiotic Stewardship in Healthcare Facilities in Low- and Middle-Income Countries: A Systematic Review of Qualitative Studies.Antibiotics (Basel, Switzerland) · 2026Review
- Impact of WHO AWaRe Antibiotic Handbook training on antibiotics prescribing knowledge among private primary care providers: a vignette-based, prep-post pilot study in Patna, India.Antimicrobial resistance and infection control · 2026Article
- Rule-Breaking and Rulemaking: Governance of the Antibiotic Value Chain in Rural and Peri-Urban India.Antibiotics (Basel, Switzerland) · 2025Article
- Antibiotic prescribing practices, perceived constraints, and views on antimicrobial resistance among general and orthopedic surgeons in central India.Scientific reports · 2025Article
- Importance of hospital-specific antibiotic policy for ensuring maternal quality of care in India: A narrative review.Journal of family medicine and primary care · 2025Review
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- Knowledge, Attitudes, Motivations, Expectations, and Systemic Factors Regarding Antimicrobial Use Amongst Community Members Seeking Care at the Primary Healthcare Level: A Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future.Frontiers in pharmacology · 2025Review
- Walking a tightrope: perspectives of non-degree allopathic providers (NDAPs) on providing diabetes and hypertension care in urban informal settlements of Mumbai Metropolitan Region.BMC health services research · 2024Article
- Leveraging the social networks of informal healthcare providers for universal health coverage: insights from the Indian Sundarbans.Health policy and planning · 2024Article
- Antimicrobial Stewardship in Healthcare: Exploring the Role of Nurses in Promoting Change, Identifying Barrier Elements and Facilitators-A Meta-Synthesis.Healthcare (Basel, Switzerland) · 2024Review
- Knowledge attitude and practice of antibiotic use among medical students in Bangladesh: A cross-sectional study.Health science reports · 2024Article
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- Drivers of inappropriate use of antimicrobials in South Asia: A systematic review of qualitative literature.PLOS global public health · 2024Article
- Hospital Pharmacists' Viewpoint on Quality Use of Antibiotics and Resistance: A Qualitative Exploration from a Tertiary Care Hospital of Quetta City, Pakistan.Antibiotics (Basel, Switzerland) · 2023Article
- Irrational use of antibiotics without a clinical diagnosis: a short case report.African health sciences · 2023Article
- Perceptions of effective policy interventions and strategies to address antibiotic misuse within primary healthcare in India: A qualitative study.Journal of infection prevention · 2023Article
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMisuse of antibiotics is a well-known driver of antibiotic resistance. Given the decentralized model of the Indian health system and the shortage of allopathic doctors in rural areas, a wide variety of healthcare providers cater to the needs of patients in urban and rural settings. This qualitative study explores the drivers of antibiotic use among formal and informal healthcare providers as well as patients accessing care at primary health centers across Paschim Bardhaman district in West Bengal. MATERIALS AND
methodsWe conducted 28 semi-structured, in-depth interviews with four groups of healthcare providers (allopathic doctors, informal health providers, nurses, and pharmacy shopkeepers) as well as patients accessing care at primary health centers and hospitals across Paschim Bardhaman district. Qualitative data was analyzed using the framework method in an inductive and deductive manner.
resultsOur results indicate that patients demand antibiotics from healthcare providers and seek the fastest cure possible, which influences the prescription choices of healthcare providers, particularly informal health providers. Many allopathic doctors provide antibiotics without any clinical indication due to inconsistent follow up, lack of testing facilities, risk of secondary infections, and unhygienic living conditions. Pharmaceutical company representatives actively network with informal health providers and formal healthcare providers alike, and regularly visit providers even in remote areas to market newer antibiotics. Allopathic doctors and informal health providers frequently blame the other party for being responsible for antibiotic resistance, and yet both display interdependence in referring patients to one another.
conclusionsA holistic approach to curbing antibiotic resistance in West Bengal and other parts of India should focus on strengthening the capacity of the existing public health system to deliver on its promises, improving patient education and counseling, and including informal providers and pharmaceutical company representatives in community-level antibiotic stewardship efforts.
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