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Antibiotic resistance misunderstood by public, new study reveals

Many members of the public do not believe they personally contribute to the growing problem of antibiotic resistance, and mistakenly believe that the body becomes resistant to antibiotics rather than the bacteria growing resistant to the antibiotics.

That is part of the findings of extensive research undertaken by Bond University’s Centre for Research in Evidence-Based Practice on the Gold Coast and published today in the Journal of Antimicrobial Chemotherapy.

Bond University’s Dr Amanda McCullough said the research involved reviewing 54 studies involving a total of 55,225 people. It showed that, on average, across the studies 70 percent of people had heard of antibiotic resistance, but most did not understand it.

"Antibiotic resistance affects everyday life; any time an antibiotic is used the individual’s risk of developing resistance increases," said Dr McCullough.

"This resistance can spread to family and other members of the community creating a pool of resistant bacteria. These resistant bacteria become problematic when an infection occurs and antibiotics that would have treated the infection are no longer effective.

"Our research found that 88 percent of participants questioned believed the body becomes resistant to the antibiotics, rather than the bacteria becoming resistant to the antibiotics.

“However gaps in knowledge are not the main issue, as more than 70 percent knew that using too many or unnecessary antibiotics caused antibiotic resistance.

“The main problem is patients did not think that they used too many or that their antibiotic use was unnecessary, in fact, they typically thought other people were the main issue.”

Dr McCullough said it is not only the general public that thinks this way. A review of 57 studies involving 11,593 health professionals showed that on average, across studies, 98 percent thought it was a serious problem, but less than 70 percent thought it was a problem for their clinical practice.

“Around half said that antibiotic resistance influenced whether or not they prescribed an antibiotic to a patient, and more than 90 percent of health professionals knew using too many antibiotics caused antibiotic resistance,” she said.

“However, some said they did not see it as a priority when faced with treating an individual patient and attributed responsibility to patients, other countries and healthcare settings.”

Dr McCullough said it was unclear why people did not think they personally contributed to antibiotic resistance, but it was easy to overlook individual contributions as ‘a drop in the ocean’.

“The consequences of antibiotic resistance may be seen as distant and dehumanised, fostering a belief that ‘it will not happen to me’,” she said.

“In contrast, sitting with a doctor in a one-on-one consultation is very much a personal interaction where the doctor and their patient might be more concerned about treating a specific infection.

“This type of thinking is an example of the ‘tragedy of the commons’ where shared resources are used for individual benefit until the point where they are used up and nobody can benefit.

“Many people also tend to believe that they ‘need something’ when they are sick and doctors may feel pressured to meet their patient’s expectations of treatment.

“The facts are that antibiotics offer little or no benefit for the treatment of some common illnesses like colds, coughs and sore throats. But antibiotic resistance is everyone’s problem. It is individuals who decide to use antibiotics, and it is individuals who have the power to minimise antibiotic resistance.”

A copy of the Journal of Antimicrobial Chemotherapy article can be viewed at: https://academic.oup.com/jac/article/71/1/27/2363966

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