BACKGROUND: Interventions promoting evidence based antibiotic prescribing and use frequently build on the concept of antibiotic resistance but patients and clinicians may not share the same assumptions about its meaning. OBJECTIVE: To explore patients' interpretations of 'antibiotic resistance' and to consider the implications for strategies to contain antibiotic resistance. DESIGN: Multi country qualitative interview study. PARTICIPANTS: One hundred and twenty-one adult patients from primary care research networks based in nine European countries who had recently consulted a primary care clinician with symptoms of Lower Respiratory Tract Infection (LRTI). APPROACH: Semi-structured interviews with patients following their consultation and subjected to a five-stage analytic framework approach (familiarization, developing a thematic framework from the interview questions and the themes emerging from the data, indexing, charting, and mapping to search for interpretations in the data), with local network facilitators commenting on preliminary reports. RESULTS: The dominant theme was antibiotic resistance as a property of a 'resistant human body', where the barrier to antibiotic effectiveness was individual loss of responsiveness. Less commonly, patients correctly conceptualized antibiotic resistance as a property of bacteria. Nevertheless, the over-use of antibiotics was a strong central concept in almost all patients' explanations, whether they viewed resistance as located in either the body or in bacteria. CONCLUSIONS: Most patients were aware of the link between antibiotic use and antibiotic resistance. The identification of the misinterpretation of antibiotic resistance as a property of the human body rather than bacterial cells could inform clearer clinician-patient discussions and public health interventions through emphasising the transferability of resistance, and the societal contribution individuals can make through more appropriate antibiotic prescribing and use.
BACKGROUND: Interventions promoting evidence based antibiotic prescribing and use frequently build on the concept of antibiotic resistance but patients and clinicians may not share the same assumptions about its meaning. OBJECTIVE: To explore patients' interpretations of 'antibiotic resistance' and to consider the implications for strategies to contain antibiotic resistance. DESIGN: Multi country qualitative interview study. PARTICIPANTS: One hundred and twenty-one adult patients from primary care research networks based in nine European countries who had recently consulted a primary care clinician with symptoms of Lower Respiratory Tract Infection (LRTI). APPROACH: Semi-structured interviews with patients following their consultation and subjected to a five-stage analytic framework approach (familiarization, developing a thematic framework from the interview questions and the themes emerging from the data, indexing, charting, and mapping to search for interpretations in the data), with local network facilitators commenting on preliminary reports. RESULTS: The dominant theme was antibiotic resistance as a property of a 'resistant human body', where the barrier to antibiotic effectiveness was individual loss of responsiveness. Less commonly, patients correctly conceptualized antibiotic resistance as a property of bacteria. Nevertheless, the over-use of antibiotics was a strong central concept in almost all patients' explanations, whether they viewed resistance as located in either the body or in bacteria. CONCLUSIONS: Most patients were aware of the link between antibiotic use and antibiotic resistance. The identification of the misinterpretation of antibiotic resistance as a property of the human body rather than bacterial cells could inform clearer clinician-patient discussions and public health interventions through emphasising the transferability of resistance, and the societal contribution individuals can make through more appropriate antibiotic prescribing and use.
Authors: C William Wester; Lakshmi Durairaj; Arthur T Evans; David N Schwartz; Shahid Husain; Enrique Martinez Journal: Arch Intern Med Date: 2002-10-28
Authors: Iruka N Okeke; Keith P Klugman; Zulfiqar A Bhutta; Adriano G Duse; Philip Jenkins; Thomas F O'Brien; Ariel Pablos-Mendez; Ramanan Laxminarayan Journal: Lancet Infect Dis Date: 2005-09 Impact factor: 25.071
Authors: Jochen W L Cals; Dennis Boumans; Robert J M Lardinois; Ralph Gonzales; Rogier M Hopstaken; Christopher C Butler; Geert-Jan Dinant Journal: Br J Gen Pract Date: 2007-12 Impact factor: 5.386
Authors: Maria-Manuel Azevedo; Sofia Costa-de-Oliveira; Rita Teixeira-Santos; Ana P Silva; Isabel M Miranda; Carmen Lisboa; Cidália Pina-Vaz; Acácio G Rodrigues Journal: Braz J Microbiol Date: 2018-11-30 Impact factor: 2.476
Authors: E Charani; E Castro-Sanchez; N Sevdalis; Y Kyratsis; L Drumright; N Shah; A Holmes Journal: Clin Infect Dis Date: 2013-04-09 Impact factor: 9.079
Authors: Christie Cabral; Jenny Ingram; Patricia J Lucas; Niamh M Redmond; Joe Kai; Alastair D Hay; Jeremy Horwood Journal: Ann Fam Med Date: 2016-03 Impact factor: 5.166
Authors: Maria João Fonseca; Catarina L Santos; Patrício Costa; Leonor Lencastre; Fernando Tavares Journal: PLoS One Date: 2012-09-12 Impact factor: 3.240
Authors: Maria-Manuel Azevedo; Céline Pinheiro; John Yaphe; Fátima Baltazar Journal: Int J Environ Res Public Health Date: 2013-07-15 Impact factor: 3.390
Authors: Sarah Tonkin-Crine; Sibyl Anthierens; Nick A Francis; Curt Brugman; Patricia Fernandez-Vandellos; Jaroslaw Krawczyk; Carl Llor; Lucy Yardley; Samuel Coenen; Maciek Godycki-Cwirko; Christopher C Butler; Theo J M Verheij; Herman Goossens; Paul Little; Jochen W Cals Journal: NPJ Prim Care Respir Med Date: 2014-07-17 Impact factor: 2.871