Exploring Patient Awareness and Perceptions of the Appropriate Use of Antibiotics: A Mixed-Methods Study

Abstract

In the outpatient setting, estimates suggest that 30% of the antibiotics prescribed are unnecessary. This study explores patient knowledge and awareness of appropriate use of antibiotics and expectations regarding how antibiotics are used for their treatment in outpatient settings. A survey was administered to a convenience sample of patients, parents, and caregivers (n = 190) at seven primary care clinics and two urgent care locations. Fisher’s exact tests compared results by patient characteristics. Although 89% of patients correctly believed that antibiotics work well for treating infections from bacteria, 53% incorrectly believed that antibiotics work well for treating viral infections. Patients who incorrectly believed that antibiotics work well for treating viral infections were more than twice as likely to expect a provider to give them an antibiotic when they have a cough or common cold. Patients who completed the survey also participated in semi-structured interviews (n = 4), which were analyzed using thematic analysis. Patients reported experiencing confusion about which illnesses may be treated by antibiotics and unclear communication from clinicians about the appropriate use of antibiotics. Development of easy to understand patient educational materials can help address patients’ incorrect perceptions of appropriate antibiotic use and facilitate patient-provider communication.

Knowledge and Expectations on Antibiotic Use among Older Adults in Malaysia: A Cross-Sectional Survey

“…This finding is comparable to previous studies in Malaysia, whereby more than 80% of adult respondents in Putrajaya [37] and Penang [35], and elderly respondents in Cheras [28] also failed to identify that antibiotics do not eradicate viral infections. The finding of the misconception that antibiotics work on both bacterial and viral infections was not uncommon in other studies in the world [26,30,31,38,43,45,48,57,58], because the general public incorrectly believed that antibiotics can speed up the recovery from most cough and cold [21,24,30,45,48,52]. In addition, more than half of the respondents in this study were not able to differentiate antibiotics from other commonly used medications such as analgesics and antipyretics, similar to that reported in Penang (69.1%) [35].…”

“…Previous work has discussed the benefits of using the specific terms "bacteria" and "virus" when providing medical consultations to patients [57]. In addition, frequent prescribing of antibiotics in viral infections and inconsistency in antibiotic prescribing by different prescribers for the same symptoms might have caused confusion to older adults [31].…”

“…Patients who were unaware of the consequences of antibiotic overuse to the community were found to expect antibiotics from their prescriber [29]. Studies have found that those who incorrectly believed that antibiotics will work for viral infections were more likely to expect antibiotics from prescribers [30,31]. Patients' expectations of antibiotics are found to be an important predictor of antibiotic prescribing [32,33].…”

An informed public's views on reducing antibiotic overuse

“…Our findings regarding limited public understanding about the potential harms of antibiotic overuse are reflected in other studies, which suggest that patients may lack awareness and/or may not view this issue as personally relevant . Furthermore, two systematic reviews of interventions aimed at reducing antibiotic prescriptions for children with respiratory tract infections found that the most effective interventions simultaneously target parents and clinicians .…”

“…Indeed, these results collectively suggest that participants see roles for patients, physicians, and the government in addressing an- Our findings regarding limited public understanding about the potential harms of antibiotic overuse are reflected in other studies, which suggest that patients may lack awareness and/or may not view this issue as personally relevant. 13,14,33,44…”