Paper short abstract:

Antimicrobial stewardship (AMS) interventions are gaining traction as solutions to the problem of antimicrobial resistance (AMR) in healthcare settings. With the ethnographic case of PROA interventions in Spain, I explore how they may offer a territory to imagine change in healthcare work.

Paper long abstract:

In policy settings, antimicrobial resistance (AMR) is anticipated to have a crucial impact on the near future of healthcare across the globe. In an scenario in which antimicrobial drugs are framed as scarce and increasingly depleting resources, the implementation of antimicrobial stewardship (AMS) interventions has been proposed as a direct solution, particularly in high-income settings. I will draw my analysis from an ethnographic study of these interventions in the context of Spain —known as Programas para la Optimizacion de Antimicrobianos (PROAs)—, where the implementation of these programmes is increasingly encouraged in public hospitals and other healthcare settings by professionals and state officials alike. In this paper, I will argue that healthcare professionals (primarily clinicians, pharmacists and microbiologists) are not only drawn into taking part of PROA teams and activities in public hospital institutions due to an ethical mandate to preserve antibiotics and provide good care for patients, and a shared understanding of the past wrong-doing of overusing antibiotics that has drove us to today’s situation in regards to AMR. PROAs are also appreciated as an exhilarating opportunity to imagine institutional change; a distinct territory to rehearse other modes of engaging in healthcare work and work relationships. PROA, as one participant put it, delivers “a taste for good work” and carrying out a fulfilling kind of healthcare labour in an otherwise strained healthcare system and often reckless work environment.