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Harmless, friendly and lethal: antibiotic misuse in relation to the unpredictable bacterium Group A streptococcus
1Department of Sociology, Uppsala University, Sweden.
Abstract:
Evidence-based treatment guidelines for managing infections in health care are promoted as tools to prevent unnecessary use of antibiotics. Antibiotic misuse has been examined as regards the doctor-patient relation and the social context of medical practice. Less attention has been paid to how the very conceptualisation of human-microbial relations may influence understandings of antibiotic misuse. The article examines a medical controversy concerning guidelines for managing throat infection and antibiotic treatment in Sweden. It demonstrates how this controversy unfolds around two different ways of relating to a specific bacterium - Group A Streptococcus. The analysis shows how two 'microbiopolitics', involving different understandings of human-microbial relations, are created in the controversy and how different antibiotic prescribing practices are justified. By focusing on Group A Streptococcus, which is commonly observed, but also unpredictable and potentially dangerous, the article provides new insights into the relations between bacteria, humans and policy in an age of antimicrobial resistance. It argues, in particular, that the definition of antibiotic misuse is unstable and consequently that policy measures aimed at reducing misuse must be related to how specific infections and bacteria are conceptualised in the actual context the policy addresses.
Insights
Understanding human-microbial relations is key to addressing antibiotic misuse. Different conceptualizations of bacteria like Group A Streptococcus shape treatment guidelines and prescribing practices, impacting antimicrobial resistance strategies.
Area of Science:
- Medical Sociology
- Public Health Policy
- Infectious Disease Management
Background:
- Evidence-based guidelines aim to curb antibiotic misuse, yet focus on doctor-patient dynamics and social contexts.
- The conceptualization of human-microbial relationships' influence on antibiotic misuse remains underexplored.
- Antimicrobial resistance necessitates novel approaches beyond traditional guideline adherence.
Purpose of the Study:
- To examine a Swedish medical controversy surrounding throat infection management and antibiotic treatment guidelines.
- To analyze how differing views on human-microbial interactions shape antibiotic prescribing practices.
- To investigate the role of specific bacterial conceptualizations in defining antibiotic misuse.
Main Methods:
- Analysis of a medical controversy in Sweden concerning Group A Streptococcus (Streptococcus pyogenes) management.
- Examination of differing 'microbiopolitics' and their influence on antibiotic prescribing justifications.
- Qualitative analysis of how conceptualizations of bacteria impact policy and practice.
Main Results:
- The controversy highlights two distinct 'microbiopolitics' based on different understandings of human-microbial relations.
- These differing perspectives justify varied antibiotic prescribing practices for throat infections.
- The definition and perception of antibiotic misuse are shown to be context-dependent and unstable.
Conclusions:
- Conceptualizing human-microbial relations is crucial for understanding and addressing antibiotic misuse.
- Policy interventions to reduce antibiotic misuse must consider the specific context and conceptualization of infections and bacteria.
- Managing common yet potentially dangerous bacteria like Group A Streptococcus requires nuanced policy informed by evolving scientific understanding.
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