The ‘Drug Bag’ method: Lessons from anthropological studies of antibiotic use in Africa and South-East Asia

Justin Dixon*, Eleanor MacPherson, Salome Manyau, Susan Nayiga, Yuzana Khine Zaw, Miriam Kayendeke, Christine Nabirye, Laurie Denyer Willis, Coll de Lima Hutchison, Clare I.R. Chandler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Understanding the prevalence and types of antibiotics used in a given human and/or animal population is important for informing stewardship strategies. Methods used to capture such data often rely on verbal elicitation of reported use that tend to assume shared medical terminology. Studies have shown the category ‘antibiotic’ does not translate well linguistically or conceptually, which limits the accuracy of these reports. This article presents a ‘Drug Bag’ method to study antibiotic use (ABU) in households and on farms, which involves using physical samples of all the antibiotics available within a given study site. We present the conceptual underpinnings of the method, and our experiences of using this method to produce data about antibiotic recognition, use and accessibility in the context of anthropological research in Africa and South-East Asia. We illustrate the kinds of qualitative and quantitative data the method can produce, comparing and contrasting our experiences in different settings. The Drug Bag method produce accurate antibiotic use data as well as provide a talking point for participants to discuss antibiotic experiences. We propose it can help improve our understanding of antibiotic use in peoples’ everyday lives across different contexts, and our reflections add to a growing conversation around methods to study ABU beyond prescriber settings, where data gaps are currently substantial.
Original languageEnglish
Article number1639388
Pages (from-to)1-11
Number of pages11
JournalGlobal Health Action
Issue number1
Early online date24 Jul 2019
Publication statusPublished - 2019

Keywords / Materials (for Non-textual outputs)

  • antibiotic resistance
  • antibiotic use
  • antimicrobial resistance
  • household surveys
  • pile sorting


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