Patterns and Determinants of Inappropriate Antibiotic Use in Injection Drug Users

In a series of focus groups, injection drug users reported experiencing discrimination and mistreatment when seeking antibiotics at emergency care facilities. Perceived differences in the quality of care contributed to patterns of avoidance and delay in seeking antibiotics.

This article examines patterns of antibiotic use among injection drug users in three stages: (1) seeking care for infections; (2) obtaining antibiotics; and (3) implementing an antibiotic regimen. Initial focus group questions addressed prior infections; previous experiences with care providers; sources of and beliefs about antibiotics. Researchers then refined questions to facilitate open-ended discussion at subsequent focus groups. The authors analyzed transcripts using NVivo qualitative analysis software and the constant comparative method of analysis. 

Key Findings:

  • Participants felt that their previous experiences receiving treatment at emergency departments discouraged them from returning.
  • Many participants in the focus groups reported obtaining antibiotics from nonprovider sources including family, friends and other drug users.
  • Participants expressed concern that antibiotics would interact with their drug of choice, lessening the effects or causing undesirable complications.

Misuse of antibiotics contributes to the spread of drug resistant infections. This qualitative study constitutes initial research toward developing an intervention to improve antibiotic use among injection drug users.