Antimicrobial resistance, inflammatory responses: a comparative analysis of pathogenicities, knowledge hybrids and the semantics of antibiotic use
Antimicrobial resistance, inflammatory responses: a comparative analysis of pathogenicities, knowledge hybrids and the semantics of antibiotic use
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DOI：
10.1057/s41599-019-0293-y
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发表时间：
2019-07-30
影响因子：
4
通讯作者：
Cabral, Christie
中科院分区：
文献类型：
--
作者：
Lambert, Helen;Chen, Meixuan;Cabral, Christie
抗生素耐药性被广泛认为是对人类健康的全球威胁。本文探讨了动员生物医学概念和技术在当地语义寄存器，并解决了翻译和知识的复杂性，试图减轻抗生素耐药性的问题的影响。在中国，抗生素经常被用于常见的疾病，并且在没有处方的情况下广泛使用。在一个省的三个农村县的实地研究，我们表明，目前的抗生素使用模式的结果，社会文化，经济和系统的驱动程序内的医疗背景下，借鉴了从生物医学和中医知识的戒律。与欧洲环境的比较分析表明，致病性，一套解释框架的生产疾病，不同的社会时间的因果机制，优先考虑。在诊断策略中，直接治疗对感染的身体反应，而不是感染病原体，“抗炎药”作为亚洲部分地区抗生素的流行术语，突出了微生物入侵的生理过程。我们研究了生物医学知识范式在非巴氏环境中与社会历史过程的关系，包括本体论上不同的医学传统之间的杂交和支持当代抗生素处方实践的科学知识主张的异质性。我们的结论是，炎症的概念功能作为一个边界对象，有效地调解流行知识，生物医学科学和当地的医疗实践之间的接口。我们的分析可能具有广泛的相关性，因为对炎症的流行和科学理解都借鉴了基于普遍感觉经验的隐喻，为文化多样性的概念阐述提供了共同的基础。对炎症和相关治疗偏好的情境理解构成了对社区卫生保健中可用医疗技术的上下文一致响应。我们的分析还质疑了对非细菌性疾病使用抗生素的简单解释，即缺乏教育或公众意识，并建议需要重新考虑目前的公共卫生知识翻译策略。
Antimicrobial resistance is widely recognised as a global threat to human health. This paper explores the mobilisation of biomedical concepts and technologies within local semantic registers and addresses the implications of translation and knowledge complexity for attempts to mitigate the problem of antibiotic resistance. In China, antibiotics are frequently prescribed for common complaints and are widely available without prescription. Drawing on field research in three rural counties of one province, we show that current patterns of antibiotic use are the result of sociocultural, economic and systems drivers within a medical context that draws on precepts from both biomedicine and Chinese medical knowledge. Comparative analysis with European settings suggests that pathogenicity, the set of explanatory frameworks regarding the production of disease, varies socio-temporally in the causal mechanisms that are prioritised. Incorporated within diagnostic strategies that direct treatment towards the bodily response to infection rather than to the infecting pathogen, 'anti-inflammatory medicine' as the popular term for antibiotics in parts of Asia foregrounds physiological process over microbial invasion. We examine the articulation of biomedical knowledge paradigms within a non-Pasteurian milieu in relation to socio-historical process, including hybridisation between ontologically distinct medical traditions and the heterogeneity of scientific knowledge claims that underpin contemporary practices of antibiotic prescribing. We conclude that the concept of inflammation functions as a boundary object which effectively mediates the interfaces between popular knowledges, biomedical sciences and local medical practices. Our analysis may have wide relevance because popular and scientific understandings of inflammation alike draw on metaphors grounded in universal sensory experience that provides a common basis for culturally diverse conceptual elaboration. Situated understandings of inflammation and associated treatment preferences constitute a contextually coherent response to available medical technologies in community health care. Our analysis also calls into question simplistic interpretations of antibiotic use for non-bacterial conditions as deriving from lack of education or public awareness and suggests a need to reconsider current public health knowledge translation strategies.