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Antibiotics online: digital pharmacy marketplaces and pastiche medicine
  1. Ben Lyall1,
  2. Anthony K J Smith2,
  3. Katie Attwell3,
  4. Mark D M David McGregor Davis4
  1. 1School of Media, Film and Journalism, Monash University, Caulfield, Victoria, Australia
  2. 2Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
  3. 3School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
  4. 4School of Social Sciences, Monash University, Clayton, Victoria, Australia
  1. Correspondence to Dr Ben Lyall, School of Media, Film and Journalism, Monash University, Clayton, Victoria 3800, Australia; ben.lyall{at}


The internet enables access to information and the purchasing of medical products of various quality and legality. Research and regulatory attention have focused on the trafficking of illicit substances, potential physical harms of pharmaceuticals, and possibilities like financial fraud. However, there is far less attention paid to antibiotics and other antimicrobials used to treat infections. With online pharmacies affording greater access, caution around antibiotic use is needed due to the increasing health risks of antimicrobial resistance (AMR). The COVID-19 pandemic has helped to normalise digital healthcare and contactless prescribing, amplifying the need for caution. Little is known of how antibiotics are consumed via digital pharmacy and implications for AMR prevention. To expand insight for AMR prevention policy in Australia and internationally, we use digital ethnographic methods to explore how digital pharmacies function in the context of health advice and policy related to AMR, commonly described as antimicrobial stewardship. We find that digital pharmacy marketplaces constitute ‘pastiche medicine’. They curate access to pharmaceutical and information products that emulate biomedical authority combined with emphasis on the ‘self-assembly’ of healthcare. Pastiche medicine empowers the consumer but borrows biomedical expertise about antibiotics, untethering these goods from critical medicine information, and from AMR prevention strategies. We reflect on the implications of pastiche medicine for AMR policy, what the antibiotics case contributes to wider critical scholarship on digital pharmacy, and how medical humanities research might consider researching online consumption in future.

  • sociology
  • internet
  • Health policy
  • Qualitative Research
  • science communication

Data availability statement

Data are available upon reasonable request. Research data may be available upon reasonable request.

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Data availability statement

Data are available upon reasonable request. Research data may be available upon reasonable request.

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  • Twitter @benlyal, @anthonykjsmith

  • Correction notice This article has been corrected since it was published Online First. An author name has been amended.

  • Contributors BL: Guarantor for final work. Contritbutor in: Methodology, Data curation, Investigation, Formal analysis, Writing—original draft, Writing

    —review and editing. AS: Validation, Writing—original draft, Writing—review and editing. KA: Co-conceptualisation, Validation, Writing—review and editing, Supervision. MD: Resources, Investigation, Conceptualisation, Methodology, Validation, Supervision, Project administration, Funding acquisition.

  • Funding The research on which this publication is based, was supported by an Australian Research Council (ARC) Discovery Project grant (DP170100937).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.