Private import of antibiotics to Norway: a qualitative study on international students coming from out of EØS

Abstract

This study is a qualitative study investigating the private import of antibiotics by international students coming from out of EØS to Norway. Background: Antibiotic resistance is one of the biggest global threats and a growing challenge in today’s world. To reduce the antibiotic resistance worldwide the main goal is to reduce antibiotic use. Self-antibiotic therapy is widely practiced in many low- and middle-income countries but may also affect high-income countries in some ways. It may be assumed that private antibiotic importation by migrants, as in Norway, can compromise the containment of the low prevalence of antibiotic resistance due to the diverse populations and relatively high levels of immigration. Aim: The aim of the study was to explore the reasons behind private importation of antibiotics by international students as well as investigating their self-medication habits and their understanding and perceptions of antibiotic resistance. Investigating the effect of Covid-19 pandemic on antibiotic importation behaviors of the students and its association with antibiotic resistance was other objectives of the study. Design and methodology: Due to Covid-19 pandemic and traveling limitations, participants were chosen from international students who had come to Oslo before the pandemic. 14 international students coming from out of EØS were interviewed to perform a qualitative study. Findings from the interviews were analyzed through a thematic analysis. Results: the most common reasons which many of the participants have referred to were that they knew access to antibiotics to be very difficult in Norway. Considering the free access to antibiotics and the habit of using abundance antibiotics in their home countries, they felt the urge to import antibiotics with them as a precaution when moving to Norway. Students with a health background used more antibiotics and intended to renew their stock when possible, while students with non-health background showed more of a tendency to adapt to the Norwegian health system, using less antibiotics and having less of a tendency to renew their stock. Antibiotic resistance was identified by most of the students as a health threat, especially in their home countries, regardless of their correct technical understanding of the phenomenon. This remained with no apparent effect on their self-medication habits though. Most of the participants shared the same points of view towards the possibility of elevated antibiotic consumption in the Covid-19 situation. they also thought of importing more antibiotics if they were supposed to move to Oslo in pandemic situation. Conclusion: private import of antibiotics and self-medication with antibiotics is actively practiced by international students and immigrants, though further and more comprehensive studies are needed to investigate the magnitude of the phenomenon and its relationship with the antibiotic resistance in Norway.