Prescription in peril: the sociology of antibiotics and antimicrobial resistance in low resource settings

The escalating threat of antimicrobial resistance (AMR) presents a significant public health challenge, particularly in low-resource settings where access to appropriate healthcare and medications is limited. While biological factors such as genetic mutations and horizontal gene transfer are fundamental drivers of AMR, sociological forces also play a substantial role in its emergence and spread. Nevertheless, the sociology antibiotic use, and access in low-resource settings is often overlooked. This commentary addresses the intricate sociological aspects, including sociocultural, political, and economic factors that contribute to suboptimal antibiotic use and the proliferation of AMR in these settings. Drawing on numerous reports from low- and middle-income countries, it is evident that patient health beliefs, provider prescribing practices, pharmaceutical supply chains, and broader health system weaknesses intersect to drive inappropriate antibiotic consumption. The impact of social disparities, poverty, limited health literacy, and the unregulated drug markets' shadow economy undermine efforts to ensure responsible antibiotic use, making it critically significant. Consequently, it is imperative to develop tailored interventions that address the nuanced social dynamics perpetuating the crisis of antibiotic resistance in resource-limited’ communities. The findings highlight an urgent need to initiate and strengthen community-based interventions through multifaceted strategies targeting individual behaviors, healthcare system capacities, and the broader sociopolitical determinants of antimicrobial use and resistance.