Thirty in-depth interviews in Siem Pang district, northeastern Cambodia, showed that over-the-counter antibiotic use reflects cost, distance, convenience, urgent household needs, and dispensers' economic pressures as well as limited knowledge. Participants balanced immediate access against safety and household benefit against collective antimicrobial-resistance risks. Qualitative evidence explains context rather than prevalence or causation.
Key findings
- Five themes covered knowledge gaps, access-versus-safety trade-offs, household needs, autonomy without reliable information, and dispensers' moral justifications.
- Some dispensers framed sales as both community help and economic necessity.
- Education alone may have limited effect while affordability and access barriers remain.
Why this matters globally
The study warns against relying on sales restrictions alone where formal care is costly or distant. Sustainable stewardship may require education, dispenser incentives, referral pathways, and affordable diagnosis and care.
Thai researcher contribution
Eight Mahidol Oxford Tropical Medicine Research Unit authors contributed, showing how a Thailand-based platform can address regional ethics, access, and antimicrobial-resistance questions without treating Cambodian evidence as direct evidence about Thailand.
Limitations to consider
Thirty participants from one rural district, purposive and snowball recruitment, self-report, and interpretive thematic analysis limit generalizability. The design cannot estimate prevalence or establish causality.