Healthcare workers' knowledge, attitudes and behaviours with respect to antibiotics, antibiotic use and antibiotic resistance across 30 EU/EEA countries in 2019.

BackgroundWhile several studies have assessed knowledge, attitudes and behaviours of the public, physicians and medical students in a number of EU/EEA countries with respect to antibiotic use and antibiotic resistance, there is a paucity of literature for other healthcare workers. This survey aimed to fill this gap.MethodsA 43-item online questionnaire was developed, validated and pilot-tested through a modified Delphi consensus process involving 87 Project Advisory Group (PAG) members, including national representatives and members of European health professional groups. The survey was distributed by the PAG and via social media to healthcare workers in 30 EU/EEA countries.ResultsRespondents (n = 18,365) from 30 EU/EEA countries participated. Knowledge of antibiotics and antibiotic use was higher (97%) than knowledge of development and spread of antibiotic resistance (75%). Sixty percent of respondents stated they had received information on avoiding unnecessary prescribing, administering or dispensing of antibiotics. Among respondents who prescribed, administered or dispensed antibiotics, 55% had provided advice on prudent antibiotic use or management of infections to patients, but only 17% had given resources (leaflets or pamphlets). For community and hospital prescribers, fear of patient deterioration or complications was the most frequent reason (43%) for prescribing antibiotics that were considered unnecessary. Community prescribers were almost twice as likely as hospital prescribers to prescribe antibiotics due to time constraints or to maintain patient relationships.ConclusionIt is important to move from raising awareness about prudent antibiotic use and antibiotic resistance among healthcare workers to designing antimicrobial stewardship interventions aimed at changing relevant behaviours.

Antimicrobial Stewardship: Development and Pilot of an Organisational Peer-to-Peer Review Tool to Improve Service Provision in Line with National Guidance.

Antimicrobial resistance continues to be a considerable threat to global public health due to the persistent inappropriate use of antibiotics. Antimicrobial stewardship (AMS) programs are essential in reducing the growth and spread of antibiotic resistance, in an environment which lacks incentives for the development of new antibiotics. Over the years, a variety of resources have been developed to strengthen antimicrobial stewardship. However, the differences in resources available present a challenge for organisations/teams to establish the best resources to utilise for service provision. A peer review tool was formulated using four national documents on AMS and tested through three phases with feedback. A survey method was used to collect feedback on the validity, feasibility, and impact of the AMS peer review tool. Feedback received was positive from the earlier pilots. The tool was found to be useful at identifying areas of good practice and gaps in antimicrobial stewardship across various pilot sites. Feedback suggests the tool is useful for promoting improvements to AMS programs and highlights that the content and features of the tool are appropriate for evaluating stewardship.

Demographic, Knowledge and Impact Analysis of 57,627 Antibiotic Guardians Who Have Pledged to Contribute to Tackling Antimicrobial Resistance.

In 2014, Public Health England (PHE) developed the behavioural change Antibiotic Guardian (AG) campaign to tackle antimicrobial resistance (AMR). This included an online pledge system aimed at healthcare professionals (HCP) and the public. Demographics of AGs were collected when pledging online and analysed by pledge group, type, geography, and source of hearing of the campaign between 24/07/2014⁻31/12/2017. Website visitors and acquisition routes were described using Google analytics data. From November 2016, five questions assessed AMR knowledge which was compared to published Eurobarometer AMR survey results for UK. Behaviour change of AGs was also assessed through an impact questionnaire, evaluating the effect of the campaign on self-reported behaviour around AMR. Overall there were 231,460 unique website visitors from 202 countries resulting in 57,627 English and 652 foreign language pledges. Website visitors increased each year with peaks during European Antibiotic Awareness Day and (EAAD) World Antibiotic Awareness Week (WAAW). Self-direction was the largest acquisition route (55%) with pledges more likely via this route than social media (OR 2.6, 95% CI 2.5⁻2.6). AGs (including the public) were more likely to answer questions correctly than the Eurobarometer UK group (OR 8.5, 95% CI 7.4⁻9.9). AG campaign engagement has increased over the four years with particular increases in the student group. AGs had greater knowledge compared to the Eurobarometer UK population. The latest impact evaluation of the online pledge scheme highlights that it continues to be an effective and inexpensive way to engage people with the problem of AMR especially among those with prior awareness of the topic.