Inflammatory responses: UTI & AMR

This thesis considers the roles currently set out for patient and public involvement on antimicrobial resistance (AMR) and clinical care in the UK. Taking the example of uncomplicated community - acquired UTI in people treated under clinical guidelines written for women, I conceptualise what alternative roles there might be for different publics and patients. Uncomplicated UTI has long been identified by both patients and health care practitioners (HCPs) as an area of poor patient care and mo re recently has become a target of antimicrobial stewardship policy mobilisations. The condition has largely been neglected outside of biomedical and policy - orientated literature. This thesis makes a contribution informed by feminist theory by keeping marg inalised experiences central. The thesis argues that public health efforts to engage the public on AMR and clinical efforts to care for people with urinary symptoms largely adopt depressed outlooks. With empirical work based on 29 semi-structured online object - based interviews with participants in the role of patients, 18 supplementary interviews with diverse HCPs, researchers and advocates, and grey literature such as clinical guidelines and engagement materials, I examine how the problem of AMR and UTI i s enacted, considering how evidence could be assembled differently in order to enact the problem in a more caring way. Working with Annemarie Mol’s concept of ontological multiplicity, I follow the argument that good care for urinary symptoms can be found in clinical experimentation due to the way it works with multiplicity. However, I depart from Mol’s work in finding such experimentation not in the practices of HCPs, which I find to be organized around rather singular antibiotic care practices. Instead, I point out a wealth of expertise in the practices of patients who care for their bladders outside of standard uses of antibiotics. Finding pessimism and depression in efforts to conserve antibiotics through compliance, the thesis offers bountiful ways to a pproach difference.