A systematic review of the public's knowledge and beliefs about antibiotic resistance
Authors: A.R. McCullough, S. Parekh, J. Rathbone, C.B. Del Mar, & T.C. Hoffman
Objectives: The objective of this study was to systematically review quantitative and qualitative studies on the public’s knowledge and beliefs about antibiotic resistance.
Methods: We searched four databases to July 2014, with no language or study design restrictions. Two reviewers independently extracted data. We calculated the median (IQR) of the proportion of participants who agreed with each statement and synthesized qualitative data by identifying emergent themes.
Results: Of 3537 articles screened, 54 studies (41 quantitative, 3 mixed methods and 10 qualitative) were included (55225 participants). Most studied adults (50; 93% studies) and were conducted in Europe (23; 43%), Asia (14; 26%) or North America (12; 22%). Some participants [median 70% (IQR 50%–84%); n¼8 studies] had heard of antibiotic resistance, but most [median 88% (IQR 86%–89%); n¼2 studies] believed it referred to changes in the human body. Many believed excessive antibiotic use [median 70% (IQR 59%–77%); n¼11 studies] and not completing antibiotic courses [median 62% (IQR 47%–77%); n¼8 studies] caused resistance. Most participants nominated reducing antibiotic use [median 74% (IQR 72%–85%); n¼4 studies] and discussing antibiotic resistance with their clinician (84%, n¼1 study) as strategies to reduce resistance. Qualitative data supported these findings and additionally identified that: participants believed they were at low risk from antibiotic resistance participants; largely attributed its development to the actions of others; and strategies to minimize resistance should be primarily aimed at clinicians.
Conclusions: The public have an incomplete understanding of antibiotic resistance and misperceptions about it and its causes and do not believe they contribute to its development. These data can be used to inf