Cultures of resistance? A Bourdieusian analysis of doctors’ antibiotic prescribing

Broom, Alexander, Broom, Jennifer and Kirby, Emma (2014) Cultures of resistance? A Bourdieusian analysis of doctors’ antibiotic prescribing. Social Science & Medicine, 110 81-88. doi:10.1016/j.socscimed.2014.03.030

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Author Broom, Alexander
Broom, Jennifer
Kirby, Emma
Title Cultures of resistance? A Bourdieusian analysis of doctors’ antibiotic prescribing
Journal name Social Science & Medicine   Check publisher's open access policy
ISSN 0277-9536
Publication date 2014-06
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.socscimed.2014.03.030
Open Access Status
Volume 110
Start page 81
End page 88
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Pergamon
Collection year 2015
Language eng
Abstract The prospect of an ‘antimicrobial perfect storm’ in the coming decades through the emergence and proliferation of multi-resistant organisms has become an urgent public health concern. With limited drug discovery solutions foreseeable in the immediate future, and with evidence that resistance can be ameliorated by optimisation of prescribing, focus currently centres on antibiotic use. In hospitals, this is manifest in the development of stewardship programs that aim to alter doctors' prescribing behaviour. Yet, in many clinical contexts, doctors' antibiotic prescribing continues to elude best practice. In this paper, drawing on qualitative interviews with 30 Australian hospital-based doctors in mid-2013, we draw on Bourdieu's theory of practice to illustrate that ‘sub-optimal’ antibiotic prescribing is a logical choice within the habitus of the social world of the hospital. That is, the rules of the game within the field are heavily weighted in favour of the management of immediate clinical risks, reputation and concordance with peer practice vis-à-vis longer-term population consequences. Antimicrobial resistance is thus a principal of limited significance in the hospital. We conclude that understanding the habitus of the hospital and the logics underpinning practice is a critical step toward developing governance practices that can respond to clinically ‘sub-optimal’ antibiotic use.
Keyword Australia
qualitative interviews
infection control
hospital medicine
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 28 March 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
School of Social Science Publications
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Citation counts: TR Web of Science Citation Count  Cited 15 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 15 times in Scopus Article | Citations
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Created: Wed, 02 Apr 2014, 10:28:16 EST by Associate Professor Alexander Broom on behalf of School of Social Science