PHP2 - Schools' Perspective on Promoting Rational use of Antibiotics in New Delhi, India – A Qualitative Study

Abstract

At community level, inappropriate antibiotic usage effected through factors like misinformed notions on antibiotics and self-medication are major factors contributing to antimicrobial resistance (AMR). The most malleable user group at community level is students. Teachers can have a deep impact on students who are both current and future users of antibiotics as well as influential advisors to parents. Hence, this study targeted high school students as well as teachers to assess their baseline knowledge, attitude and practices towards antibiotic use, acknowledging the role of schools in contributing to a sustainable mitigation of AMR. Five focus group discussions (FGDs) with high school students (class 9-11) and five with teachers were conducted in 2 private and 3 public schools in five municipal wards of Delhi. Qualitative data on antibiotic knowledge and behaviors with respect to antibiotics use were collected. There were 4-8 persons per FGD of teachers and 15-20 persons per student FGD. The findings had been previously analyzed but were re-analyzed in-depth to understand the imbalance in power relation between doctors and patients and strategies to improve antibiotic use. Emerging themes were: desire to get instant cure with some ‘strong medicines’; self-medication; using old prescriptions; unequal power relation between doctor and patient so patients cannot ask question; doctors do not/ are perceived by the group that do not undertake proper history/examination/proper counseling. Strategies suggested for improving use of antibiotics: awareness through mass media and also involving school teachers, students and celebrities as was done for polio program; school curriculum to include AMR and appropriate use of antibiotics; training the doctors for counseling and interactive with patients; and stricter regulation for labeling and selling for antibiotics. School education programs and public education could be used to promote behavior change with regard to antibiotic use and AMR containment.