Evidence map›Paper›PMID 39464857›Full record

ReviewJAC-antimicrobial resistance2024

Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence.

Christie Cabral, Tingting Zhang, Isabel Oliver, Paul Little, Lucy Yardley, Helen Lambert

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in JAC-antimicrobial resistance, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Christie CabralCentre for Academic Primary Care, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.ORCID https://orcid.org/0000-0002-9884-0555
Tingting ZhangCentre for Academic Primary Care, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.
Isabel OliverUnited Kingdom Health Security Agency, Chief Scientific Officer's Group, London, UK.
Paul LittlePrimary Care Research Centre, University of Southampton, Southampton SO16 5ST, UK.
Lucy YardleySchool of Psychological Science, University of Bristol, The Priory Road Complex, Priory Road, Clifton, Bristol BS8 1TU, UK.
Helen LambertDepartment of Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Identifiers

PMID39464857
PMCPMC11503652

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.