The Construction of Patient Understandings of Antibiotic use for Upper Respiratorytract Infections in Rural China.
Abstract Background: This paper seeks to identify the lay understandings concerning “anti-inflammatories”, their relation to antibiotics, and their utilization in treating upper respiratory tract infections (RTIs) among patients in rural Anhui Province, China. Methods: In-depth semi-structured interviews were carried out with 30 patients from rural clinics who presented with RTI symptoms between December 2017 and May 2018. These patient-informants were purposively sampled for follow-up interviews from an original sample of 1,030 patients who completed preliminary structured interviews. All informants were over 18 years old and had consulted a doctor at village- or township-level government health facilities for symptoms of RTIs within two weeks preceding follow-up interviews. Data was collected until saturation was achieved. Responses were audiotaped, transcribed, and analyzed using a thematic framework via NVivo 12.0 software. Results: A majority of informants reported that antibiotics such as cephalosporin, known colloquially as “anti-inflammation medicine”, are the preferred treatment for upper respiratory tract symptoms. These are commonly prescribed by township and village doctors, who are an important source of antibiotic-related information for patients. Approximately 87% (n=26) of patient informants reported that doctors neither revealed the name nor classification of their diagnosis. Only 13% (n=4) were specifically told they had an upper respiratory tract infection. However, all patients in this sample were treated with antibiotics regardless of diagnosis or pathogenic etiology. Conclusion: The findings of the present study may provide important insights for designing future interventions to promote public health awareness concerning unnecessary and inappropriate use of antibiotics in China.