Drew University, USA
Title: Culture and resistance: Antibiotic resistance in rural china and sociocultural translations of biomedicine
Biography: Paul Kadetz
There is an assumption among biomedical practitioners that biomedicine is always understood and practiced in the same way in every culture and that, somehow, biomedicine is free from sociocultural influences. This mixed-methods pilot research employing structured interviews and observation in clinical settings and retail pharmacies- in rural Anhui, China, funded by the Medical Research Council and Newton Fund (UK) and the National Science Foundation of China identifies how sociocultural translations of biomedicine and local classifications of disease and pharmacotherapies can be imperative, but heretofore unrecognized, factors in antibiotic resistance. In addition to the overuse of antibiotics in livestock, that has entered the general food chain in China, our pilot study has identified misdiagnosis, overuse of antibiotics in treatment, and abundant purchase of antibiotics without prescriptions from retail pharmacies, as potential factors in antibiotic resistance in China. We observed little differentiation between bacterial and viral infections in clinical diagnosis and treatment; with both being commonly categorized as inflammation or infection by physicians, retail pharmacy workers and patients. Similarly, treatment was often for medicine that eliminates infection and for literally resist life medicine. Though physicians may intellectually understand the differential diagnoses between viruses and bacteria, in practice patients are often treated with intravenous antibiotics regardless of the actual etiology. This focus on treating most infections with antibiotics is mirrored in the self-treatment of retail pharmacy customers (almost all of whom were observed purchasing antibiotics without a prescription) and in the recommendations of retail pharmacy workers. These initial findings from the pilot study will guide the main research over the next two years, in which, among other areas, we will further investigate the role of political economy and the pricing and availability of antibiotics in their markedly frequent use.