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Updated: Oct 2, 2025
Antibiotic Dereplication Using the Antibiotic Resistance Platform
Published on: October 17, 2019
'She Wanted to Listen to her General Practitioner's Advice…': Exploring and Explaining Antibiotic Prescribing as a
1Faculty of Law, University of Technology Sydney, Ultimo NSW 2007, Australia; Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo NSW 2007, Australia.
Abstract:
This article examines the pressing global problem of antimicrobial resistance (AMR), applying motivational posture theory to demonstrate how AMR and the prescribing that drives it can be considered a regulatory challenge. Following an outline of AMR and the threat of the 'superbugs' to which it gives rise, the article assesses the regulatory nature of the 'prescribing encounter' in the primary care setting. It applies both a responsive regulatory lens and motivational posture theory to analyse over 100 narrative accounts of encounters between a general practitioner and a patient. In so doing, the article examines the discursive repertoires and cultural resources available to primary care patients to explain the prescribing encounter and the dynamics within it. It concludes that patients conceive of prescribers as regulatory authorities and prescribing itself as a regulatory encounter. On this basis, the article argues that applying responsive regulatory theory and practice in response to the AMR challenge is likely to find reasonable patient acceptance, offering a new approach to this currently intractable challenge. This article then offers an analysis of what factors indicate patient drift towards defiance of regulatory aims, and what engagement and support encourage a return to cooperation.
Insights
Antimicrobial resistance (AMR) is a regulatory challenge. Patients view prescribers as authorities, suggesting responsive regulation can help combat AMR by encouraging cooperation.
Area of Science:
- Public Health
- Health Policy
- Behavioral Science
Background:
- Antimicrobial resistance (AMR) poses a significant global health threat, driven by prescribing practices.
- The 'superbug' crisis necessitates novel approaches to managing AMR.
- Understanding patient-prescriber dynamics is crucial for effective interventions.
Purpose of the Study:
- To analyze antimicrobial resistance (AMR) and prescribing through the lens of regulatory theory.
- To explore patient perceptions of the prescribing encounter in primary care.
- To assess the potential of responsive regulatory approaches to address AMR.
Main Methods:
- Application of motivational posture theory and responsive regulatory theory.
- Analysis of over 100 narrative accounts of general practitioner-patient encounters.
- Examination of patient discursive repertoires and cultural resources.
Main Results:
- Patients perceive general practitioners as regulatory authorities.
- Prescribing encounters are understood by patients as regulatory interactions.
- Factors influencing patient cooperation or defiance in regulatory aims were identified.
Conclusions:
- Responsive regulatory theory offers a promising, patient-accepted strategy for tackling AMR.
- Understanding patient perspectives is key to designing effective regulatory interventions for AMR.
- Engaging patients and providing support can foster cooperation with regulatory goals in primary care settings.
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