Antibiotic optimisation in 'the bush': Local know-how and core-periphery relations. (November 2017)

• Record Type: Journal Article
• Authors: Broom, Alexander; Broom, Jennifer; Kirby, Emma; Gibson, Alexandra; Davis, Mark
• Is Part Of: Health & place. Volume 48(2017:Nov.)
• Page Start: 56
• Page End: 62
• Publication Date: 2017-11
• Subjects: Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2017.09.003
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: The growing global concern around antimicrobial mis-use and proliferating resistance has resulted in increasing interest in optimising antibiotics, particularly in hospitals. While the agenda to tighten antibiotic use has been critically explored in metropolitan settings, the dynamics of rural and remote settings have remained largely unexplored. Drawing on 30 interviews with doctors, nurses, and pharmacists in a remote Australian hospital, we focus on the pertinence of setting, and its importance for contextualising and potentially achieving antibiotic optimisation. Building on previous work on the dynamics of locale and core-periphery relations, here we consider how antimicrobial practice is deeply embedded in experiences of being on the geographical periphery, and crucially, at the periphery of (established) knowledge. Highlights: Rich, in-depth qualitative data on experiences of practice in a remote setting. Critical exploration of core-periphery relations of infection management. Builds on previous work on the dynamics of locale, as applied to antibiotic use. Reveals setting as vital in contextualising and enacting antibiotic optimisation. Practice shaped by experiences of being at the periphery of established knowledge.