Awareness of Appropriate Antibiotic Use in Primary Care for Influenza-Like Illness: Evidence of Improvement from UK Population-Based Surveys
Koen B. Pouwels,
Laurence S. J. Roope,
James Buchanan,
Liz Morrell,
Sarah Tonkin-Crine,
Michele Peters,
Leah F. Jones,
Enrique Castro-Sánchez,
Derrick W. Crook,
Tim Peto,
Christopher C. Butler,
Julie V. Robotham,
A. Sarah Walker,
Sarah Wordsworth
Affiliations
Koen B. Pouwels
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Laurence S. J. Roope
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
James Buchanan
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Liz Morrell
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Sarah Tonkin-Crine
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford OX1 2JD, UK
Michele Peters
Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Leah F. Jones
Primary Care and Interventions Unit, Public Health England, Gloucester GL1 1DQ, UK
Enrique Castro-Sánchez
School of Health Sciences, Division of Nursing, University of London, London EC1V 0HB, UK
Derrick W. Crook
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford OX1 2JD, UK
Tim Peto
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford OX1 2JD, UK
Christopher C. Butler
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford OX1 2JD, UK
Julie V. Robotham
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford OX1 2JD, UK
A. Sarah Walker
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford OX1 2JD, UK
Sarah Wordsworth
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Influenza-like illnesses (ILI) account for a significant portion of inappropriate antibiotic use. Patient expectations for antibiotics for ILI are likely to play a substantial role in ‘unnecessary’ antibiotic consumption. This study aimed to investigate trends in awareness of appropriate antibiotic use and antimicrobial resistance (AMR). Three sequential online surveys of independent representative samples of adults in the United Kingdom investigated expectations for, and consumption of, antibiotics for ILI (May/June 2015 (n = 2064); Oct/Nov 2016 (n = 4000); Mar 2017 (n = 4000)). Respondents were asked whether they thought antibiotics were effective for ILI and about their antibiotic use. Proportions and 95% confidence intervals (CI) were calculated for each question and interactions with respondent characteristics were tested using logistic regression. Over the three surveys, the proportion of respondents who believed antibiotics would “definitely/probably” help an ILI fell from 37% (95% CI 35–39%) to 28% (95% CI 26–29%). Those who would “definitely/probably” visit a doctor in this situation fell from 48% (95% CI 46–50%) to 36% (95% CI 34–37%), while those who would request antibiotics during a consultation fell from 39% (95% CI 37–41%) to 30% (95% CI 29–32%). The percentage of respondents who found the information we provided about AMR “new/surprising” fell from 34% (95% CI 32–36%) to 28% (95% CI 26–31%). Awareness improved more among black, Asian and minority ethnic (BAME) than white people, with little other evidence of differences in improvements between subgroups. Whilst a degree of selection bias is unavoidable in online survey samples, the results suggest that awareness of AMR and appropriate antibiotic use has recently significantly improved in the United Kingdom, according to a wide range of indicators.
