Mehtarpour Mojtaba, Najafi Zahra, Jaafaripooyan Ebrahim
Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
East Hormozgan School of Medical Sciences, Minab, Iran.
BMC Public Health. 2025 Jul 10;25(1):2425. doi: 10.1186/s12889-025-23361-4.
Antimicrobial resistance (AMR) is a growing global public health threat that is highly likely to undermine modern medicine and pose significant risks to health systems and national economies worldwide. As such, its complex nature, as affected by biological, environmental, economic, and sociocultural factors, requires a multidisciplinary approach to its control. Therefore, uncovering the sociocultural drivers of AMR is critical to designing effective interventions, particularly in low- and middle-income countries.
This qualitative study included a number of 57 semi-structured, face-to-face interviews with policymakers, managers, and service providers from both human and animal health sectors using purposive and snowball sampling techniques. The data were subsequently analyzed employing thematic analysis.
Several sociocultural factors were uncovered contributing to the development of AMR, in relation mainly with general public culture, public drug use culture, cultural barriers among service providers, and demographic changes in the country.
Sociocultural factors within both human and animal health sectors might significantly influence the antimicrobials usage and the proliferation of AMR across diverse ecosystems, underscoring the imperative for policymakers to consider them when devising interventions to combat AMR. Policymakers are advised to prioritize the development of clinical guidelines, enhance insurance oversight, and improve diagnostic capabilities in an effort to effectively address the challenge of AMR.
抗菌药物耐药性（AMR）是一个日益严重的全球公共卫生威胁，极有可能破坏现代医学，并对全球卫生系统和国家经济构成重大风险。因此，其受生物、环境、经济和社会文化因素影响的复杂性质，需要采取多学科方法来加以控制。所以，揭示AMR的社会文化驱动因素对于设计有效的干预措施至关重要，尤其是在低收入和中等收入国家。
这项定性研究采用立意抽样和滚雪球抽样技术，对来自人类和动物卫生部门的政策制定者、管理人员和服务提供者进行了57次半结构化面对面访谈。随后采用主题分析法对数据进行了分析。
发现了几个导致AMR产生的社会文化因素，主要与公众文化、公众药物使用文化、服务提供者之间的文化障碍以及该国的人口变化有关。
人类和动物卫生部门的社会文化因素可能会显著影响抗菌药物的使用以及AMR在不同生态系统中的扩散，这突出表明政策制定者在制定应对AMR的干预措施时必须考虑这些因素。建议政策制定者优先制定临床指南，加强保险监管，并提高诊断能力，以有效应对AMR挑战。
