Antibiotic prescribing behavior among physicians: ethical challenges in resource-poor settings

Area of Science:

• Medical Ethics
• Public Health
• Infectious Disease

Background:

• Antibiotic prescribing presents an ethical dilemma, requiring a balance between immediate patient needs and long-term antimicrobial resistance (AMR) containment.
• Overuse of antibiotics is a primary driver for the development of AMR in communities.
• Conventional biomedical ethics, particularly beneficence and justice, are challenged by prescribing practices in resource-poor settings.

Purpose of the Study:

• To explore the influence of social realities on physician antibiotic prescribing behavior in resource-poor settings.
• To identify how socioeconomic factors and patient demand impact ethical considerations in antibiotic prescription.
• To analyze the inadequacy of current AMR containment strategies in addressing ethically complex prescribing practices.

Main Methods:

• Qualitative analysis of social factors influencing physician prescribing.
• Examination of ethical principles (beneficence, justice) in relation to prescribing behavior.
• Review of current antimicrobial resistance strategies in developing countries.

Main Results:

• Social factors such as patient socioeconomic status, demand for antibiotics, practitioner competition, and physician-patient relationships significantly influence prescribing.
• These factors can lead to subtle violations of medical ethics, contributing to irrational antibiotic use.
• Current approaches to combating AMR often fail to adequately address these ethically driven prescribing practices.

Conclusions:

• Addressing antimicrobial resistance requires a deeper understanding of the complex social and ethical dimensions of antibiotic prescribing in resource-poor settings.
• Ethical frameworks must evolve to incorporate social realities influencing physician behavior.
• More effective strategies are needed to combat irrational antibiotic use driven by ethical conflicts.