Risking Antimicrobial Resistance: A collection of one-health studies of antibiotics and its social and health consequences

233 Pages·2019·2.99 MB·English

by  Carsten Strøby Jensen

Risking
Antimicrobial
Resistance
A collection of one-health studies
of antibiotics and its social
and health consequences
Edited by Carsten Strøby Jensen,
Søren Beck Nielsen and Lars Fynbo
Risking Antimicrobial Resistance
Carsten Strøby Jensen
Søren Beck Nielsen • Lars Fynbo
Editors
Risking Antimicrobial
Resistance
A collection of one-health studies of
antibiotics and its social and health
consequences
Editors
Carsten Strøby Jensen Søren Beck Nielsen
Department of Sociology Department of Nordic Studies
University of Copenhagen and Linguistics
Copenhagen, Denmark University of Copenhagen
Copenhagen, Denmark
Lars Fynbo
VIVE – The Danish Center for Social
Science Research
Copenhagen, Denmark
ISBN 978-3-319-90655-3 ISBN 978-3-319-90656-0 (eBook)
https://doi.org/10.1007/978-3-319-90656-0
Library of Congress Control Number: 2018947888
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Preface
Antimicrobial resistance (AMR) has become one of the twenty-first cen-
tury’s major health challenges. Since World War II, antimicrobials have
been widely used to fight bacterial diseases in humans. Diseases that were
once serious and sometimes fatal to humans could be cured or prevented
using antimicrobials. However, the successful use of antimicrobials has
also had a drawback. Each and every time antimicrobials are used, these
create a risk that the bacteria being treated will develop resistance.
Antimicrobials, therefore, have become less and less effective over time,
and antimicrobial resistance (AMR) has emerged as one of our major
health risks.
In Risking Antimicrobial Resistance, we have set out to analyze the
development of AMR within an explicitly social science perspective.
While AMR can be seen as belonging fundamentally to the health sci-
ences area, its development, its risks, and the public debate surrounding
AMR are replete with important social science issues. For example, there
are major differences among countries in the amount of antibiotics used
to treat the same types of diseases. These national differences in consump-
tion have little to do with the actual epidemiology of infections and are
more indicative of differences between countries in terms of habits, cul-
ture, legislation, and economics.
This book is the result of a research project at the University of
Copenhagen, entitled ‘UC-care’ (University of Copenhagen Center for
v
vi Preface
Control of Antibiotic Resistance). The Center is a multidisciplinary
research center that brings together researchers from many departments
across the university. The UC-Care project was launched by the University
of Copenhagen in 2012 as part of the university’s enhanced focus on
interdisciplinary cooperation on selected key issues. Hence, UC-Care
involved researchers from the health sciences, veterinary science, social
sciences, and the humanities. This book presents some of the results of
the social and humanities part of the project, and the authors are all affili-
ated with UC-Care and the University of Copenhagen.
In connection with the book, there are a number of people we wish to
thank. First, we wish to thank Professor Luca Guardabassi of the
University of Copenhagen and Ross University’s School of Veterinary
Medicine. Having taken the initiative for the UC-Care project, Professor
Guardabassi has been instrumental in obtaining funds for carrying out
the research for this book. We also wish to thank Professor Anders Miki
Bojesen of the University of Copenhagen for his work as Principal
Investigator in the second half of the UC-Care project. We also express
our gratitude to our fellow UC-Care participants from the health and
veterinary fields for their enthusiastic cooperation with those of us from
the social sciences and humanities.
We also wish to express our thanks to the many interviewees and par-
ticipants (notably patients and doctors) who, as described in the chapters
of the book, kindly agreed to be interviewed, observed, or video-recorded
by the researchers involved. Overall, the book’s chapters are based on
interviews with more than 200 people. This research could not have been
accomplished without the active participation of the Interviewees, and
for this we are extremely grateful.
Our book has been improved by the anonymous reviewers who com-
mented on each of the chapters in the book. Their efforts are highly
appreciated.
In completing the manuscript, we wish to thank Anna Gørting Jensen
and Steven Sampson. Anna Gørting Jensen helped in editing the manu-
script and keeping track of the individual chapters. Steven Sampson’s
language editing helped in ensuring that our ideas could be expressed in
the best possible English.
Prefac e vii
Finally, we wish to thank Palgrave for being willing to publish the
book and for their patience during the process of completing the
manuscript.
Any defects in the book, of course, are solely our own.
Copenhagen, Denmark Carsten Strøby Jensen
Copenhagen, Denmark Søren Beck Nielsen
Copenhagen, Denmark Lars Fynbo
January 2018
Contents
1 Risking Antimicrobial Resistance: A One Health Study
of Antibiotic Use and Its Societal Aspects 1
Carsten Strøby Jensen, Søren Beck Nielsen, and Lars Fynbo
2 Dealing with Explicit Patient Demands for Antibiotics
in a Clinical Setting 25
Søren Beck Nielsen
3 Antibiotics in France and Italy: A Linguistic Analysis
of Policies and Practices Compared to Danish Standards 41
Kirsten A. Jeppesen Kragh and Erling Strudsholm
4 Talk on Cough: Symptom, Sign and Significance in Acute
Primary Care 61
Johanna Lindell
ix
x Contents
5 ‘To Prescribe or Not to Prescribe’ is Not the Only
Question: Physician Attitudes Towards Antibiotics
and Prescription Practices in Spain 79
Sandi Michele de Oliveira, Nieves Hernández-Flores, and
Vanesa Rodríguez-Tembrás
6 Governing the Consumption of Antimicrobials:
The Danish Model for Using Antimicrobials
in a Comparative Perspective 95
Carsten Strøby Jensen
7 My Life as a Pig: MRSA and the Control of Life
in Contemporary Pig Production 111
Lars Fynbo
8 Social Stigmatization of Pig Farmers: Medical
Perspectives on Modern Pig Farming 127
Carsten Strøby Jensen and Lars Fynbo
9 What is ‘Good Doctoring’ When Antibiotic Resistance
is a Global Threat? 143
Inge Kryger Pedersen and Kim Sune Jepsen
10 Governing Risk by Conveying Just Enough
(Un)Certainty: Rearticulating Good Doctoring as a 
Psy-Medical Competence 163
Mads Bank and Anne Rogne
11 The Antibiotic Challenge: Justifications for Antibiotic
Usage in the World of Medicine 183
Kim Sune Jepsen and Inge Kryger Pedersen
Conten ts xi
12 Concluding Remarks on ‘Risking Antimicrobial
Resistance’ 199
Carsten Strøby Jensen, Søren Beck Nielsen, and Lars Fynbo
Index 209