Antibiotic Therapy from Both Sides of the Counter and Both Sides of the Border

Antimicrobial resistance is recognized as a significant and serious public health threat, both in the US and globally. There is very clear evidence that ‘inappropriate' use of antibiotics is driving the burgeoning problem, due to both lay use without adequate medical oversight as well as health workers prescribing or recommending the drugs indiscriminately.  In the border towns of northern Mexico, where large numbers of pharmacies serve both Mexican locals and American medical tourists seeking non- prescription antibiotics (and other drugs), these store counters are a very specific locale at which different—potentially very different—cultural models of health and treatment are expressed, negotiated, and acted on. The purpose of this study is to map cognitively the conceptual diversity that surrounds the act of buying OTC antibiotics and their subsequent use in Nogales, Sonora, just across the border from Arizona. Using formal ethnographic methods, we are studying how pharmacy personnel and their diverse clients think similarly and differently about antibiotic efficacy, use, and safety, and considering how this might help us better understand why so many people are eager to use antibiotics so freely despite grave potential individual and public health consequences.