Experiences of antibiotic use among Brazilian healthcare users: An exploratory study

• Published in: Health expectations : an international journal of public participation in health care and health policy 2023-02, Vol.26 (1), p.343-354
• Main Authors: Zago, Luiz F., Correa, Juliana S., Silva‐Brandão, Roberto R., Fracolli, Lislaine A., Padoveze, Maria Clara, Oliveira, Sandi Michele, Corboda Currea, Gloria C.
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; antibiotic use; Antibiotics; Antimicrobial agents; Antimicrobial resistance; Ascription; Bacteria; Bacterial diseases; Bacterial infection; Bacterial infections; Bacterial Infections - drug therapy; Brazil; Community health care; Community involvement; Content analysis; Data collection; Drug resistance; Drugs; exploratory research; Health care; Health services; Humans; Infections; Informed consent; Interviews; Knowledge; Medical personnel; Narratives; Original; Patient communication; patient experience; Patients; Personal experiences; Physician patient relationships; Physician-Patient Relations; Primary care; Qualitative Research; Recurrent; Respondents; Suburban areas; Teams; Urinary tract; Urinary tract infections
• ISSN: 1369-6513; 1369-7625; 1369-7625
• DOI: 10.1111/hex.13664

Introduction This article analyzes experiences of antibiotic use and bacterial infections among Primary Health Care users of the Brazilian Unified Health System (SUS) and the possible implications for antimicrobial resistance (AMR). The aim is to map aspects that shape users' lay knowledge regarding antibiotics use and AMR. Methods This is an exploratory study, which consists primarily of individual in‐depth interviews with 19 respondents. Recurrent interview topics were coded and analysed according to thematic content analysis. Results Our findings show users' lived experiences constitute three dimensions related to users' previous antibiotic use: (1) lay knowledge about medicines; (2) previous bacterial infections and (3) communication during the consultation. Lay knowledge encompasses the users' understanding of how antibiotics work in comparison to other drugs and experimentations they make with medication. Users' narratives about bacterial infections are divided into situations of urinary tract infections and antibiotic treatments for other conditions. Communication during the consultation is mainly characterized by a lack of shared knowledge and trust in the doctor–patient relationship. Discussion Users bring together knowledge learned from their own experiences to create the rationale, which shapes how they understand antibiotic use, bacterial infections and medical advice. These experiences are interwoven with information received from healthcare professionals (HPs) on these topics, creating a scenario that goes beyond professional information about antibiotic use. Users have knowledge about medication, antibiotics use and bacterial infection but do not have room to share it with HP, allowing lived experiences to take precedence over professional information. Conclusion Users ascribe symbolic meanings to antibiotics creating a lay knowledge frame, even if this knowledge is not scientifically correct. The personal experiences of bacterial infections and their treatment are also an important source of knowledge about antibiotic use and AMR among users. Users demand from their HPs both trust and willingness to listen to their health narratives and experiences. By considering lay knowledge as part of the assessment of a user's health condition, rather than dismissing it as erroneous and therefore unworthy of attention, HPs may enhance the compliance of users. Patient or Public Contribution Patients or community members did not participate in the design