Using the socio-ecological model in understanding antimicrobial resistance and antibiotic usage in the lakeshore communities of Calamba and Pila, Laguna, Philippines.

Lakes in low- to middle-income countries like the Philippines are increasingly contaminated with antimicrobial-resistant (AMR) determinants, particularly beta-lactam antimicrobials, leading to difficult-to-treat multidrug-resistant infections. Despite growing concerns, few interventions have been thoroughly evaluated to mitigate environmental contamination from hospitals, agriculture, and livestock production. To address this gap, this study employed a socio-ecological framework to examine the social science aspects of antibiotics use in selected lakeside communities in the Philippines. Specifically, it evaluated the knowledge, attitudes, and practices (KAP) related to proper antibiotic usage within lakeshore communities, identifying key challenges and opportunities for intervention. This mixed methods research employed KAP surveys, focus group discussions (FGDs), and key informant interviews (KIIs) in selected barangays of Calamba and Pila, lakeshore communities in Laguna. Data from the FGDs and KIIs were analyzed using inductive and deductive thematic analysis, while survey data were analyzed using descriptive statistics such as means and percentages. By applying the socio-ecological framework, the study contextualized how the environment, social dynamics at various core levels of the socio-ecological model, and public health policies, or lack thereof, converged to intensify AMR in these communities. The data collected, along with consultations with local government units, informed the recommendations for the development of educational tools and policies on antimicrobial use in community settings. As antibiotic misuse becomes more prevalent, this research underscores the critical need for targeted interventions to address AMR in lakeshore communities, emphasizing the importance of collaborative efforts between local government units and communities.