Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, New South Wales, Australia.
College of Asia & the Pacific, The Australian National University, Australian Capital Territory, Australia.
Soc Sci Med. 2022 Jan;292:114520. doi: 10.1016/j.socscimed.2021.114520. Epub 2021 Oct 29.
As social science scholarship has routinely illustrated, professional practice is rarely as contained or coherent as it is often imagined to be. The increasing emphasis on the rise of antimicrobial resistance (AMR) has drawn renewed attention to the interconnectedness of clinic, community, environment and planet, and how proposed 'solutions' to major problems such as AMR require a broad, cross-cutting lens. In this study, set in Hyderabad, India, we draw on a series of interviews with hospital-based clinicians completed during 2019 and early 2020, to unpack the multidimensional, ecological acceleration of AMR and the implications for everyday practice. Their accounts make visible how practice operates in relation to industrial economies, community vulnerabilities, and ecologies. This in turn highlights the problem of epistemic bordering, where 'sites' of AMR are targeted but are prone to leakage and transgressions. We propose an ecological approach to conceptualising antimicrobial practices with implications for AMR interventions being rolled out in the sub-continent and beyond.
正如社会科学学术研究通常所表明的那样，专业实践很少像人们通常想象的那样有界限或连贯。人们越来越关注抗生素耐药性（AMR）的上升，这引起了人们对临床、社区、环境和地球之间相互联系的重新关注，以及如何需要用广泛的、跨领域的视角来看待解决 AMR 等重大问题的“解决方案”。在这项在印度海得拉巴进行的研究中，我们借鉴了 2019 年和 2020 年初完成的一系列针对医院临床医生的访谈，以揭示 AMR 的多维、生态加速及其对日常实践的影响。他们的描述使人们清楚地看到实践是如何与工业经济、社区脆弱性和生态相关联的。这反过来又凸显了认识边界的问题，即 AMR 的“地点”是有针对性的，但容易发生泄漏和越界。我们提出了一种生态方法来概念化抗菌实践，这对在次大陆及其他地区推出的 AMR 干预措施具有重要意义。
