Measuring the Knowledge of Antibiotic Risks and Related Issues

European health care workers have a high awareness of antibiotic resistance and related issues, though knowledge gaps still remain, according to a survey published by the European Centre for Disease Control and Prevention (ECDC).

The ECDC developed a questionnaire following a systematic literature review to in order to measure knowledge, attitudes, and behaviors of health care workers regarding antibiotics, their use, and resistance. The survey consisted of 7 true/false questions about these topics and was distributed online with the hashtag #ECDCAntibioticSurvey after being translated into 25 languages. Participants completed the survey between January 28 and March 4, 2019.

The survey was completed by more than 18,000 health care workers, with 80% of countries reaching or exceeding their target quota of participants. The survey included responses from doctors, nursing professionals, dentists, and pharmacists. Other health care professionals such as hospital managers, pharmacy or dental technicians, and allied health professionals also participated, but in fewer numbers, the study authors said. Most of the health care workers who responded were over the age of 25 years, while the majority (70%) were women. The authors also noted that it’s possible that women, in general, could be more likely to participate in online surveys when compared to men. Additionally, 30% had worked in their profession for 25 years or longer, the investigators learned.

Across Europe, only 58% of the respondents answered all 7 questions correctly, the investigators found; however, medical doctors correctly answered all of the questions more often than other health care workers. After medical doctors, more scientists and pharmacists answered all of the questions correctly. The country with the highest percentage of respondents answering all 7 questions correctly was Croatia (73%), followed by Ireland (71%), and France (69%).

“The survey results showed that health care workers have, in general, a good knowledge and awareness of several key concepts regarding antibiotics and antibiotic resistance, with 97% of respondents correctly identifying that antibiotics are not effective against colds and flu,” study author Dominique Monnet, PharmD, PhD, ECDC Head of Antimicrobial Resistance Disease Program, explained to Contagion®. “This is significantly higher than among the general public, of whom only just over half know that antibiotics are ineffective against colds.”

Among health care workers who have direct patient or public involvement, 25% said they do not have easy access to guidance regarding infection management, the study authors found. Plus, a third do not have easy access to materials for advice on prudent antibiotic use and antibiotic resistance.

For those who prescribe antibiotics, which were primarily physicians, a third did not have confidence in the guidelines that were available to them.

“This suggests that more investment is needed, in [European] countries, to produce and disseminate evidence-based, independent and trusted guidance documents and resources aimed at prescribers of antibiotics and other health care workers, and to adapt this guidance and resources to the various situations in each local setting,” Monnet added.

Another key finding is that the survey takers responded “fear of a patient’s health deteriorating or fear of complications” was a key reason for initiating an antibiotic prescription, even when the health care provider would have preferred not to prescribe an antibiotic, the study authors learned. There was no difference among workers from community or hospital settings, which suggested this is a widespread issue for prescribers, the study authors wrote.

“Interventions aiming at improving the level of knowledge about antibiotics and antibiotic resistance and change physicians’ behavior and practice with antibiotics would need to be implemented in hospitals and other healthcare settings in [European] countries” Monnet concluded. “The results of this study can serve as a baseline to assess the effect of these interventions.”