Tompson A C, Manderson L, Chandler C I R
Department of Global Health & Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown 2193, Johannesburg, South Africa.
JAC Antimicrob Resist. 2021 Oct 4;3(4):dlab150. doi: 10.1093/jacamr/dlab150. eCollection 2021 Dec.
In this article, we consider how social sciences can help us to understand the rising use of antibiotics globally. Drawing on ethnography as a way to research how we are in the world, we explore scholarship that situates antibiotic use in relation to interactions of pathogens, humans, animals and the environment in the context of globalization, changes in agriculture and urbanization. We group this research into three areas: practices, structures and networks. Much of the public health and related social research concerning antimicrobial resistance has focused on antibiotic use as a practice, with research characterizing how antibiotics are used by patients, farmers, fishermen, drug sellers, clinicians and others. Researchers have also positioned antibiotic use as emergent of political-economic structures, shedding light on how working and living conditions, quality of care, hygiene and sanitation foster reliance on antibiotics. A growing body of research sees antibiotics as embedded in networks that, in addition to social and institutional networks, comprise physical, technical and historical connections such as guidelines, supply chains and reporting systems. Taken together, this research emphasizes the multiple ways that antibiotics have become built into daily life. Wider issues, which may be invisible without explication through ethnographic approaches, need to be considered when addressing antibiotic use. Adopting the complementary vantage points of practices, networks and structures can support the diversification of our responses to AMR.
在本文中，我们探讨社会科学如何帮助我们理解全球抗生素使用量不断上升的现象。借助人种志这一研究我们如何置身于世界的方法，我们探究了相关学术研究，这些研究将抗生素的使用置于全球化、农业变革和城市化背景下病原体、人类、动物及环境之间的相互作用关系中。我们将这项研究分为三个领域：实践、结构和网络。许多关于抗微生物药物耐药性的公共卫生及相关社会研究都聚焦于抗生素使用这一实践行为，研究描述了患者、农民、渔民、药品销售商、临床医生及其他人员是如何使用抗生素的。研究人员还将抗生素使用视为政治经济结构的产物，揭示了工作和生活条件、医疗质量、卫生与环境卫生如何助长了对抗生素的依赖。越来越多的研究认为抗生素嵌入于网络之中，这些网络除了包括社会和制度网络外，还涵盖诸如指南、供应链和报告系统等物质、技术和历史联系。综合来看，这项研究强调了抗生素融入日常生活的多种方式。在应对抗生素使用问题时，需要考虑一些更广泛的问题，若不通过人种志方法加以阐释，这些问题可能并不明显。采用实践、网络和结构的互补视角能够支持我们应对抗微生物药物耐药性措施的多样化。
