Antibiotic use in Türkiye: Everyday encounters of translating policy and negotiating rationality

Antibiotic use surged during COVID-19 despite it being a viral illness, heightening global concerns about antimicrobial resistance (AMR). In Türkiye - where antibiotic consumption and AMR were already high - this paradox exposed longstanding tensions between policy and practice. Türkiye has adopted World Health Organization guidelines promoting the "rational" (akılcı) use of antibiotics, yet everyday healthcare encounters reveal how these reforms are translated, negotiated and reinterpreted. Drawing on fieldwork in Istanbul, this article shows how local expectations of antibiotics as symbols of care and professional competence shape prescription and use. Rather than aligning practice with policy, stewardship reforms are absorbed into existing moral and relational norms, reinforcing rather than transforming existing dynamics of care. Global stewardship attempts, as they filter through local systems, understandings and situated priorities, are vernacularized in ways that diverge from their original intentions - redistributing accountability without addressing the structural conditions that shape antibiotic use.