Acculturation and Subjective Norms Impact Non-Prescription Antibiotic Use among Hispanic Patients in the United States

Authors

Lindsey A Laytner
Kiara Olmeda
Juanita Salinas
Osvaldo Alquicira
Susan Nash
Roger Zoorob
Michael K Paasche-Orlow
Barbara W Trautner
Larissa Grigoryan

Publication Date

9-8-2023

Journal

Antibiotics

DOI

10.3390/antibiotics12091419

PMID

37760716

PMCID

PMC10525363

PubMedCentral® Posted Date

9-8-2023

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

acculturation, subjective norms, socio-cultural factors, antibiotic resistance, non-prescription antibiotic use, antibiotic stewardship

Abstract

Using antibiotics without medical guidance (non-prescription antibiotic use) may contribute to antimicrobial resistance. Hispanic individuals are a growing demographic group in the United States (US) with a high prevalence of non-prescription antibiotic use. We investigated the effects of acculturation and subjective norms on Hispanic individuals’ intentions to use antibiotics without a prescription from the following sources: (1) markets in the United States (not legal), (2) other countries (abroad), (3) leftovers from previous prescriptions, and (4) friends/relatives. We surveyed self-identified Hispanic outpatients in eight clinics from January 2020 to June 2021 using the previously validated Short Acculturation Scale for Hispanics (SASH). Of the 263 patients surveyed, 47% reported previous non-prescription use, and 54% expressed intention to use non-prescription antibiotics if feeling sick. Individuals with lower acculturation (Spanish-speaking preferences) expressed greater intentions to use antibiotics from abroad and from any source. Individuals with more friends/relatives who obtain antibiotics abroad were over 2.5 times more likely to intend to use non-prescription antibiotics from friends/relatives (p = 0.034). Other predictors of intention to use non-prescription antibiotics included high costs of doctor visits and perceived language barriers in the clinic. Antibiotic stewardship interventions in Hispanic communities in the United States should consider the sociocultural and healthcare barriers influencing non-prescription use and promote language-concordant healthcare.

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