‘There is no choice apart from antibiotics…’: Qualitative analysis of views on urinary infections in pregnancy and antimicrobial resistance

Abstract

Abstract Background Antimicrobial resistance (AMR) is a health risk as it can lead to life‐threatening infections. There has been a rise in resistant urinary tract infections (UTIs) which is the most common infection in pregnancy. This can be challenging in pregnancy due to the additional need to safeguard foetal development. The study's aim was to explore views about AMR in women who experienced UTIs in pregnancy. Design Fifteen semi‐structured interviews were conducted in the UK and analysed using thematic analysis. Results Results highlighted two themes: conceptualization of AMR and pregnancy as a deviation from the norm, with an overarching theme of ‘self‐efficacy’. Results show that participants were concerned about AMR but uncertain about the effect on society compared to individual's taking antibiotics and about completing antibiotic courses. Participants reported an unsparing use of antibiotics was justified in pregnancy, and behaviours like drinking adequate water were ineffective at preventing UTIs. In summary, women had low self‐efficacy regards tackling AMR and managing their health. Conclusion Misconceptions about how AMR affects society vs the individual translated into viewing it as a future problem to be tackled by the health‐care sector. Consequently, AMR requires reconceptualization as a current problem requiring collective action. This research also indicates women endorse a biomedical model of UTIs in pregnancy which attributes resolving illness to interventions such as medicines, implying an automatic reliance on antibiotics. Subsequently, there is a need for self‐efficacy by focusing on a behavioural model which emphasizes behaviours for infection prevention, thus reducing the need for antibiotics.

Keywords

• antibiotic resistance
• antimicrobial drug resistance
• interviews
• pregnancy
• qualitative research
• self‐efficacy