Abstract
ObjectiveTo explore and describe how healthcare policymakers and healthcare practitioners from different levels of Swedish healthcare perceived the everyday practice of putting national policies to contain antibiotic resistance into effect.MethodA strategic sample of four healthcare policymakers, three healthcare practitioners working in hospital care, and six working in primary care were recruited and interviewed in person. A manifest and latent content analysis was carried out on the transcribed interview data.ResultsAnalysis revealed how the everyday practice of containing antibiotic resistance in different healthcare levels could be perceived as successful, difficult, or a dilemma. The informants’ perceptions are presented in three categories which describe first; informants’ perceptions of antibiotic use and antibiotic resistance in Sweden; secondly, informants’ perceptions of definable efforts in containing antibiotic resistance in Sweden, most notably responsible use of antibiotics, prevention of infection, improving public knowledge of antibiotic resistance, and international collaboration; and thirdly, informants’ perceptions of problem areas in containing antibiotic resistance in Sweden, such as behavior, attitudes and knowledge among healthcare practitioners and the public, work environment, and resources. Reflection on the underlying meaning of these perceptions led to identification of the latent theme, labelled “A sense of relative success, and many challenges yet to overcome”.ConclusionThis study has given in-depth insight into how a group of healthcare policymakers and practitioners perceived the everyday practice of containing antibiotic resistance, and revealed their perceptions of successful efforts to combat antibiotic resistance so far. It has identified problem areas in different healthcare levels, bringing to light challenges yet to overcome, and areas to focus on in future policies, most notably more emphasis on attitude and behavior change, and increasing awareness of antibiotic resistance among both healthcare practitioners and patients.
Highlights
Antibiotic resistance (AR) is recognized as a significant threat to global health in modern times [1]
Efforts to combat antibiotic resistance are being driven by global organizations, such as the World Health Organization (WHO), World Organization for Animal Health (OIE), United Nations Food and Agriculture Organization (FAO), as well as health communities in Europe, North America, and Australia [3]
This study has given in-depth insight into how a group of healthcare policymakers and practitioners perceived the everyday practice of containing antibiotic resistance in Sweden
Summary
Antibiotic resistance (AR) is recognized as a significant threat to global health in modern times [1]. WHO, OIE, and FAO have adopted a ‘One Health’ approach in work to contain AR. This approach is broadly defined as “the collaborative effort of multiple disciplines- working locally, nationally and globally–to attain optimal health for people, animals and our environment” [3]. One notable initiative has been the creation in 1995 of the Swedish strategic program against antibiotic resistance (Strama). It began as a voluntary network of professional organizations and multi-professional groups with an overall aim of safeguarding the efficiency of antibiotic treatment in humans and animals. In 2006 it was officially assigned the task of facilitating coordination of work against antibiotic resistance by the government [4, 5]
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