Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Figures & data

Table 1 Details of the Participants

Characteristics of the Participants		Number (%)
Type of participant	People with COVID-19	20 (50)
	People with suggestive symptoms	20 (50)
Gender	Male	20 (50)
	Female	20 (50)
Age	24–30	15 (37.5)
	31–40	16 (40)
	41–50	9 (22.5)
Education	MA/MSc/MSS	19 (47.5)
	BA/BSc/BSS	14 (35)
	12th grade	3 (7.5)
	10th grade	4 (10)
Occupation	Service	17 (42.5)
	Home maker	11 (27.5)
	Student	5 (12.5)
	Business	5 (12.5)
	Others	2 (5)
History of chronic disease	No chronic disease	32 (80)
	Asthma	4 (10)
	Diabetes	3 (7.5)
	Cancer	1 (2.5)
Number of times antibiotics taken in the last year	Not taken	19 (47.5)
	Yes	18 (45)
	Could not recall	3 (7.5)

Table 2 Summary of Thematic Findings

Themes	Sub-Theme	Explanations	Number of Participants	Nature of Participants
Antibiotic seeking behavior	As soon as tested positive or having symptoms.	Those who had tested positive with COVID-19 and had severe symptoms sought antibiotics to keep the health condition under “control” from further damage and manage anxiety.	16	Individuals with COVID-19=11 Individuals with symptoms=5 Gender: Man=9; Woman=7 Age group: <40= 6; >40=10 Chronic illness=8; Education: Up to BA/BSc=10; MA/MSc=6
	Seeking antibiotics when home remedies and “normal” medicines fail to cure the symptoms.	Due to the perceived side-effects of antibiotics, home remedies and normal medicines were used, and the body observed in the first place. Sought antibiotics when ailment was deteriorating.	13	Individuals with COVID-19=3 Individuals with symptoms=10 Gender: Man=5; Woman=8 Age group: <40= 4; >40=9 Education: Up to BA/BSc=7; MA/MSc=6
	When the symptoms get severe.	Sought antibiotics in the case of critical signs and symptoms of COVID-19 such as shortness of breathing, chest pain, and lower oxygen level, indicating secondary co-infection.	7	Individuals with COVID-19=6 Individuals with symptoms=1 Gender: Man=7 Age group: <40= 1; >40=6 Education: Up to BA/BSc=4; MA/MSc=3
	Close contacts tested positive with COVID-19.	Risk of spreading the virus influenced close contacts, such as other family members, to seek antibiotics.	4	Individuals with symptoms=4 Gender: Man= 1; Woman=3 Age group: <40= 4; Education: Up to BA/BSc=4
	Hesitation, dilemma, and self-negotiation.	The concern about AMR and confusion around the effectiveness and appropriateness of antibiotic use in treating a viral disease led to a dilemma.	4	Individuals with COVID-19 =4 Gender: Man=1, Woman=3 Age group: <40= 4; Education: MA/MSc=4
Antibiotics consumption behavior	Following prescribed doses.	Trusted the physician’s prescription and regimes.	13	Individuals with COVID-1=11 Individuals with symptoms=2 Gender: Man=7; Woman=6 Age group: <40= 2; >40=11 Chronic illness=8 Education: Up to BA/BSc=9; MA/MSc=4
	Following regimes for antibiotic use of others.	Recovered patient’s prescription is tested and it is believed that following that prescription and regimes would help to cure the disease and symptoms.	12	Individuals with COVID-19=2 Individuals with symptoms=10 Gender: Man=10; Woman=2 Age group: <40= 9; >40=3 Education: Up to BA/BSc=8; MA/MSc=4
	Stopped taking when felt better or on experiencing side-effects.	Stopped taking due to side effects that would cause further damage or when symptoms disappeared.	10	Individuals with COVID-19=4 Individuals with symptoms=6 Gender: Man=7; Woman=3 Age group: <40= 8; >40=2 Chronic illness=2 Education: Up to BA/BSc=6; MA/MSc=4
	Multiple suggestions, multiple regimens, and multiple antibiotics.	Sought treatments from multiple physicians when the conditions did not improve.	5	Individuals with COVID-19 =3 Individuals with symptoms=2 Gender: Man=2; Woman=3 Age group: <40= 5; Education: Up to BA/BSc=3; MA/MSc=2

Figure 1 Significant matrix of socio-cultural aspects of antibiotics seeking and consumption behaviors: retrieved from inductive, grounded theory analysis.