While most of the general public believes inappropriate antibiotic use is contributing to antibiotic resistance, only 30% considered resistance to be a “significant problem,” according to data from a recently published survey.
Furthermore, roughly one-quarter of the respondents indicated that antibiotics are an effective treatment for “most coughs and colds,” and nearly 90% believed that the body could become immune to antibiotics over time.
“The reasons for widespread antibiotic resistance are multifactorial and include providers’ practice patterns as well as the public’s perceptions about, and sometimes demands for, antibiotics,” Rebecca R. Carter, a PhD student in epidemiology and biostatistics at Case Western Reserve University, and colleagues wrote. “Our results highlight the continued need for education to the American public about the biological events that lead to antibiotic resistance.”
Few respondents view antibiotic resistance as a serious issue
Using a previously validated online crowdsourcing platform, Carter and colleagues surveyed a sample of the general U.S. adult population on antibiotic and antibiotic resistance. After an open-ended question asking participants to define antibiotic resistance, the survey consisted of several multiple-choice questions focusing on participants’ knowledge and beliefs regarding appropriate antibiotic use and related issues. The researchers quantified the responses to these questions and summarized using descriptive statistics, and employed a thematic framework analysis to identify emergent themes among the open-ended responses.
Of the 215 respondents who completed the full survey, 57% were female, and 76% were white. Compared with U.S. 2010 Census data, participants were slightly younger than the general population (median age, 37 years vs. 37.2 years; P = .048), and more often reported an undergraduate or higher level of education (47% vs. 30%; P < .001).
Ninety-three percent of participants believed inappropriate antibiotic use contributes to antibiotic resistance, and 69% of responders said reducing antibiotic use would decrease resistance. Although 76% responses agreed that resistance is a problem within hospitals, 70% responded neutrally or negatively with a statement calling antibiotic resistance a “significant problem.” Further, while 71% of respondents agreed that antibiotics are overprescribed by doctors and nurses, and 45% considered these providers to not be adequately educated on antibiotic resistance, 72% said they trusted their own doctor or nurse’s judgment on antibiotic prescription.
Ninety percent of the respondents said antibiotics were used to kill bacteria; however, 89% strongly agreed or agreed that the body could develop an immunity to certain antibiotics with time, and 29% said antibiotics are capable of killing viruses. Nearly one-quarter responded that antibiotics are effective treatments for “most coughs and colds,” and approximately 40% viewed antibiotics as appropriate treatments for fever and runny nose/sore throat symptoms.
When asked of their familiarity with “MRSA,” “Superbug” and “C. diff.,” participants most frequently reported hearing of these terms from television, the internet and a medical professional, in that order. Common themes detected in responses to the free-text question were bacteria, infection/illness and the body. Minor themes relating to the body’s immune system resisting antibiotics frequently were associated with the latter, while evolution and overexposure often were associated with the other two major themes.
Carter and colleagues wrote that these findings represent several areas of misunderstanding or antibiotic knowledge inconsistencies, many of which have been noted in other populations.
“Specific knowledge gaps are that antibiotics are effective against bacteria, not viruses, and that antibiotic resistance is a property developed by bacteria, not people,” they wrote. “Given that most of our participants indicated that they trust their doctor or nurse, these professionals may be the most effective at teaching patients about prudent antimicrobial use.”
Antibiotic misinformation more frequent among Hispanics
Previous survey data published last year noted that although antibiotic knowledge is inconsistent within the general population, it appears to be greater among Hispanics.
Louise K. Francois Watkins, MD, of the CDC’s Epidemic Intelligence Service, and colleagues analyzed data from the Internet-based Summer 2012 and Fall 2013 HealthStyles surveys. The surveys included three categories of participants: the total population of adult consumers, adult Hispanic consumers and health care providers.
The findings indicated that 40% of Hispanic consumers believed antibiotics could reduce cold severity, as opposed to 17% of the total population; 48% believed antibiotics hastened recovery vs. 25% of the total population.
One-quarter of Hispanic consumers said they were more likely to obtain antibiotics from sources other than their physician or clinic. Compared with the general population, Hispanics were less aware of antibiotic resistance or that antibiotics might kill beneficial intestinal bacteria.
“The differences in health knowledge and attitudes between Hispanic and all consumers observed in this study underscore the importance of considering cultural factors in public health messaging about appropriate antibiotic use,” they wrote. “Research is needed to investigate the influence of specific cultural factors … on health knowledge and attitudes among Hispanic as well as other minority populations.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.