Understanding the Swedish antibiotic stewardship through healthcare professionals’ meaning making of antibiotic use and antibiotic resistance in Swedish hospitals

The global antibiotic stewardship depicts antibiotic use and antibiotic resistance as constituting a global public health threat that has implications for global health, the global economy, global security and sustainability. Prudent and wise use of antibiotics have been recognized in global measures and interventions that are designed to optimize antibiotics worldwide. However, these programmes tend to overlook the social aspects and dynamics of antibiotic usage, which has important repercussions for the successful implementation of antimicrobial stewardship.

Sweden has been acclaimed internationally for its particular approach to antibiotic stewardship. The country has a low rate of antibiotic prescription and use in comparison with its European counterparts. However, despite Sweden’s commendable efforts towards a robust and well-funded antibiotic stewardship, there are still controversial moments where clinical imperatives and stewardship goals are in conflict with one another. Given the difficulties of setting priorities that encompass both stewardship and clinical goals, even in the well-resourced Swedish context, research into the social and contextual dimensions of antibiotic usage in situ is warranted.

This study explores contexts where antibiotic usage is high and clinical imperatives are demanding to explore how clinicians weigh up and interpret the various competing imperatives in their daily clinical practice. The study seeks to understand how healthcare professionals in emergency healthcare units, Medicinsk Intermerdiärvårdavdelning (MIVA) and Medicinskt Akutvårdsavdeldning (MAVA) at various Swedish hospitals reflect upon rational use of antibiotics and antibiotic resistance in their daily work. Moreover, the study explores how healthcare professionals at these emergency units relate to evidence- based guidelines on rational use of antibiotics and antibiotic resistance in hospitals.