What the public in England know about antibiotic use and resistance in 2020: a face-to-face questionnaire survey

Abstract

ObjectivesTo describe public attitudes and knowledge around antibiotic activity, resistance and use.DesignFace-to-face household 18 question survey using computer-assisted data collection undertaken by Ipsos Market and Opinion Research International.SettingRandomly selected households across England, January–February 2020.Participants2022 adults (aged 15+,) including 521 black, Asian and minority ethnic (BAME) participants, and 406 aged 15–25 years olds.Main outcome measuresResponses to questions about antibiotic activity, resistance and expectations for antibiotics and trust in healthcare professionals. Analyses were weighted to obtain estimates representative of the population with multivariable analysis undertaken for questions with five or more significant univariate variables.Results84% stated they would be pleased if their general practitioner (GP) said they did not need antibiotics. Trust in GPs to make antibiotic decisions remains high (89%) and has increased for nurses (76%) and pharmacists (71%). Only 21% would challenge an antibiotic decision; this was significantly greater in BAME participants (OR 2.5; 95% CI 1.89 to 3.35). 70% reported receiving advice when prescribed antibiotics. Belief in benefits of antibiotics for ear infections was very high (68%). Similar to 2017, 81% agreed that antibiotics work for bacterial, 28% cold and influenza viruses. 84% agreed antibiotic resistant bacteria (ARB) are increasing, only 50% agreed healthy people can carry ARB and 39% agreed there was nothing they personally could do about ARB. Social grade DE and BAME participants, and those with less education had significantly less understanding about antibiotics and resistance.ConclusionsAs trust in healthcare practitioners is high, we need to continue antibiotic education and other interventions at GP surgeries and community pharmacies but highlight that most ear infections are not benefitted by antibiotics. Targeted interventions are needed for socioeconomic DE, BAME groups and previous antibiotic users. We need to explore if increasing perceived personal responsibility for preventing ARB reduces antibiotic use.

Experiences of antibiotic use among Brazilian healthcare users: An exploratory study

“…Respondents show they know antibiotics have specific features, as they believe that antibiotics work to cure ‘chronic internal inflammation’ in the body and aid in rapid recovery. These results parallel those of other studies in that users perceive that antibiotics are a special type of drug 23,25,26 …”

“…These results parallel those of other studies in that users perceive that antibiotics are a special type of drug. 23 , 25 , 26 …”

“…These results parallel those of other studies in that users perceive that antibiotics are a special type of drug. 23,25,26 Despite viewing antibiotics as 'strong', some respondents forgo their use, choosing instead alternative practices completely outside standard medical care (e.g., off-label use of vaginal cream, creolin). If these alternative practices seem to work, these experiences reinforce the users' sense of autonomy in dealing with their own health and reliance on lived experiences and shared narratives of healing.…”

Mixed-Method Evaluation of a Community Pharmacy Antimicrobial Stewardship Intervention (PAMSI)

“…Of 2043 TARGET Antibiotic Checklists completed, patients’ reported knowledge was similar to that found in the feasibility study of PAMSI [ 20 ]; the lack of understanding of duration of infection and returning unused antibiotics to the pharmacy is common in the literature [ 20 , 25 , 30 ]. A 2020 public survey on infection health-seeking behaviours found high trust for pharmacists’ advice about the need for antibiotics, which has significantly improved since a previous survey in 2014 [ 13 ]. The public trust the advice of community pharmacy staff on common infections [ 28 , 30 ]; however, public campaigns should continue to encourage this, as in public surveys, ‘visiting a GP’ is still the most common source of health information [ 31 ].…”

“…The pharmacists and other team member’s roles in checking the appropriateness of antibiotic scripts and educating patients on appropriate antibiotic use may help improve antibiotic adherence and avoid unnecessary exposure to antimicrobials, thereby helping to reduce rates of AMR. The public trusts the advice of pharmacists on self-care and symptomatic treatment [ 13 ]. AMR has been described as a hidden pandemic; experts recognize the need to engage the public in appropriate antibiotic use and support continued heightened attention to infection prevention as displayed during the COVID-19 pandemic [ 4 , 14 ].…”