Managing Sustainable Use of Antibiotics—The Role of Trust

Robertson, Felicia; Jagers, Sverker C.; Rönnerstrand, Björn

doi:10.3390/su10010143

Cited by 9 publications

(7 citation statements)

References 53 publications

(65 reference statements)

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“…Sweden has led the way internationally in reducing antibiotic consumption in the community [31]. In Sweden, the focus was primarily on changing the behaviour of prescribers, with the knowledge and behaviour of patients and publics a secondary concern [54,55]. In the mid-1990s, Swedish governments and health authorities took a bottom up regulatory approach to the risks of AMR by establishing the The Swedish Strategic Programme Against Antibiotic Resistance (STRAMA).…”

Section: Policy and Practice Background In The Three Study Settingsmentioning

confidence: 99%

Comparing public attitudes, knowledge, beliefs and behaviours towards antibiotics and antimicrobial resistance in Australia, United Kingdom, and Sweden (2010-2021): A systematic review, meta-analysis, and comparative policy analysis

et al. 2022

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Background Social and behavioural drivers of inappropriate antibiotic use contribute to antimicrobial resistance (AMR). Recent reports indicate the Australian community consumes more than twice the defined daily doses (DDD) of antibiotics per 1000 population than in Sweden, and about 20% more than in the United Kingdom (UK). We compare measures of public knowledge, attitudes and practices (KAP) surrounding AMR in Australia, the UK and Sweden against the policy approaches taken in these settings to address inappropriate antibiotic use. Methods National antimicrobial stewardship policies in Australia, Sweden, and the UK were reviewed, supplemented by empirical studies of their effectiveness. We searched PubMed, EMBASE, PsycINFO, Web of Science and CINAHL databases for primary studies of the general public’s KAP around antibiotic use and AMR in each setting (January 1 2011 until July 30 2021). Where feasible, we meta-analysed data on the proportion of participants agreeing with identical or very similar survey questions, using a random effects model. Results Policies in Sweden enact tighter control of community antibiotic use; reducing antibiotic use through public awareness raising is not a priority. Policies in the UK and Australia are more reliant on practitioner and public education to encourage appropriate antibiotic use. 26 KAP were included in the review and 16 were meta-analysable. KAP respondents in Australia and the UK are consistently more likely to report beliefs and behaviours that are not aligned with appropriate antibiotic use, compared to participants in similar studies conducted in Sweden. Conclusions Interactions between public knowledge, attitudes and their impacts on behaviours surrounding community use of antibiotics are complex and contingent. Despite a greater focus on raising public awareness in Australia and the UK, neither antibiotic consumption nor community knowledge and attitudes are changing significantly. Clearly public education campaigns can contribute to mitigating AMR. However, the relative success of policy approaches taken in Sweden suggests that practice level interventions may also be required to activate prescribers and the communities they serve to make substantive reductions in inappropriate antibiotic use.

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Section: Policy and Practice Background In The Three Study Settingsmentioning

confidence: 99%

Comparing public attitudes, knowledge, beliefs and behaviours towards antibiotics and antimicrobial resistance in Australia, United Kingdom, and Sweden (2010-2021): A systematic review, meta-analysis, and comparative policy analysis

et al. 2022

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“…Although these are correlations, they generate hypotheses about the impact of ideology, trust, and authority on behavior related to medicines at individual and population levels. [ 183,184 ]…”

Section: Factors Driving Variation In Antibiotic Use and Overusementioning

confidence: 99%

Accounting for variation in and overuse of antibiotics among humans

2021

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Worldwide, antibiotic use is increasing, but many infections against which antibiotics are applied are not even caused by bacteria. Over‐the‐counter and internet sales preclude physician oversight. Regional differences, between and within countries highlight many potential factors influencing antibiotic use. Taking a systems perspective that considers pharmaceutical commodity chains, we examine antibiotic overuse from the vantage point of both sides of the therapeutic relationship. We examine patterns and expectations of practitioners and patients, institutional policies and pressures, the business strategies of pharmaceutical companies and distributors, and cultural drivers of variation. Solutions to improve antibiotic stewardship include practitioners taking greater responsibility for their antibiotic prescribing, increasing the role of caregivers as diagnosticians rather than medicine providers, improving their communication to patients about antibiotic treatment consequences, lessening the economic influences on prescribing, and identifying antibiotic alternatives.

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“…2 On the other hand, when using antibiotic chemical therapies, the biofilm acts as a shield, ensuring that only those bacteria at the biofilm's surface suffer damage while those inside remain unaffected. 9 This induced bacteria to develop resistance against current antibiotics, leading to the frightening prediction that bacteria-related diseases could well ARTICLE Nanoscale 2 | Nanoscale, 2022, 00, [1][2][3][4][5][6][7][8][9][10][11][12][13] This journal is © The Royal Society of Chemistry 20xx…”

Section: Introductionmentioning

confidence: 99%

“…2 The environmental impact of antibacterial technologies is increased by bacteria resistance, implying higher doses and dispersion of antibiotic substances in the environment, as well as the resorting to synthetic procedures, which pose sustainability and cost on a lower priority level. 10,11 One of the newest and most promising approaches for tackling the challenge of the growth suppression of infectious bacteria relies on the development of magnetic nanoparticles (NPs) carrying bactericidal elements. 12 Magnetic NPs respond to external magnetic fields, allowing mechanical damage to the biofilm through particle penetration, mechanical disruption, and the creation of highways for the permeation of antibacterial drugs.…”

Section: Introductionmentioning

confidence: 99%