Perceptions and attitudes regarding antibiotic resistance in Germany: a cross-sectoral survey amongst physicians, veterinarians, farmers and the general public.

Background: Drivers of antibiotic (AB) resistance (ABR) include outpatient treatment, hospital care and animal husbandry. During the first phase of the One Health project RAI (Responsible Antibiotic Use via Information and Communication) surveys were conducted in these sectors. Objectives: To compare perceptions and attitudes towards ABR among general practitioners (GPs), hospital physicians, veterinarians, pig farmers and the general public. Methods: Cross-sectional questions on AB use and ABR were integrated in group-specific surveys of GPs, hospital physicians, veterinarians, pig farmers and the German general population. Results: A total of 1789 participants (340 GPs, 170 hospital physicians, 215 pig farmers, 60 veterinarians and 1004 members of the public) responded. Each group tended to identify drivers of ABR as being from outside its own area of activity. Guidelines were shown to be an important information source for AB therapy for all prescriber groups, but the frequency of routine use differed (39% of GPs, 65% of hospital physicians and 53% of veterinarians). Regarding further information sources, hospital physicians preferred smartphone apps and e-learning, GPs preferred non-sponsored training and veterinarians preferred multidisciplinary networks and e-learning. Farmers were predominantly satisfied with existing solutions. Farmers had three times better basic knowledge of ABR and knew twice as many people with MDR organism problems than the general public. They also received information on ABR more often from their veterinarians than patients did from their doctors. Conclusions: This study reveals considerable differences in perceptions and attitudes to ABR among the groups investigated. The results can help to tailor future interventions. Furthermore, they promote mutual understanding and thus support the One Health approach.

[Antibiotic intake and resistance development - Knowledge, experience and behavior among the German general population]. / Antibiotikaeinnahme und Resistenzentwicklung - Wissen, Erfahrungen und Einnahmeverhalten innerhalb der deutschen Allgemeinbevölkerung.

BACKGROUND: The network project RAI (Rational Use of Antibiotics via Information and Communication) is aimed at developing tailored information and communication tools on the subject of antibiotic (AB) resistance for various stakeholder groups. During the preparation phase, a survey was performed addressing the German general population. OBJECTIVES: To gain insights into the knowledge, attitudes, and behavior of nonprescribers concerning AB and multidrug-resistant organisms (MDRO). METHODS: Using computer-assisted, telephone-based interviews a random sample of 1,004 persons aged 14 years and older was surveyed. Descriptive reporting of data and multivariate analysis were performed, including sociodemographic variables. RESULTS: Only 24 % of participants knew that bacteria (but not viruses or humans) could develop AB resistance. However, this knowledge did not influence the outcome of other questions. Regardless of knowledge, 71 % thought that the subject was important, but 58 % did not believe in the influence of their own behavior on MDRO development. When visiting a physician, patients were given an antibiotic three times as often as information on AB resistance. 17 % did not take the AB as prescribed and 20 % of all participants stated that they personally knew at least one person with MDRO problems. This personal involvement had a significant effect on the rating of self-influence, on the importance of the subject, on the interaction between patient and physician (more information, less AB), and on AB intake compliance (less frequent). DISCUSSION: We found considerable knowledge gaps, but this had no impact on the assessment of the subject. A starting point for an intervention could be patient-physician communication. This seems more effective and safer than a public campaign.