Antibiotics and upper respiratory infections: the impact of Asian and Pacific Island ethnicity on knowledge, perceived need, and use.

The threat of microbial resistance to antibiotics grows increasingly serious each year. Despite the severity of the problem, little is known about ways that ethnicity and culture influence antibiotic knowledge, attitudes, and use. Based on a random sample of residents from a multicultural metropolitan county in the western United States, this study finds that Filipinos have lower levels of antibiotic knowledge, express higher perceived need, and report more frequent use. Whites in this sample are at the opposite end on all of these measures; other Asian Americans and Hawaiians/Pacific Islanders are in between. The results also suggest that preference for a "paternalistic" interaction/decision-making style between Filipino patients and their physicians may increase the challenge of designing an effective intervention promoting appropriate antibiotic use; a social marketing approach may be one possible alternative. Implications and future research directions are discussed for other multicultural urban environments that experience inappropriate use of antibiotics.