Not in my backyard: A systematic review of clinicians' knowledge and beliefs about antibiotic resistance

Research output: Contribution to journalArticleResearchpeer-review

38 Citations (Scopus)

Abstract

Objectives: To systematically review clinicians' knowledge and beliefs about the importance and causes of antibiotic resistance, and strategies to reduce resistance.

Methods: Four databases were searched (until July 2014), without restrictions on language, setting or study design. Fixed responses (from surveys) were grouped into categories. The proportion of participants who agreed with each category was expressed as median, percentage and IQR. Qualitative data were coded into emergent themes. Quantitative categories and qualitative themes were grouped into four overarching categories that emerged from the data.

Results: There were 57 included studies (38 quantitative, 14 qualitative, 5 mixed methods) of 11593 clinicians. Most clinicians (69%, IQR 63%-72%, n = 5 studies) had heard of antibiotic resistance and 98% (IQR 93%-99%, n = 5 studies) believed it was serious. The proportion who believed it was a problem for their practice (67%, IQR 65%-74%, n = 13 studies) was smaller than the proportion who believed it was a problem globally (89%, IQR 85%-97%, n = 5 studies) or nationally (92%, IQR 88%-95%, n = 21 studies). Most believed excessive antibiotic use (97%, IQR 91%-98%, n = 12 studies) and patient non-adherence (90%, IQR 82%-92%, n = 7 studies) caused resistance. Most knew of strategies to reduce resistance (e.g. clinician education, 90%, IQR 85%-96%, n = 7 studies). Qualitative findings support these data: they attributed responsibility for antibiotic resistance to patients, other countries and healthcare settings; resistance was considered a low priority and a distant consequence of antibiotic prescribing.

Conclusions: Clinicians believe antibiotic resistance is a serious problem, but think it is caused by others. This needs to be accommodated in interventions to reduce antibiotic resistance.

Original languageEnglish
Pages (from-to)2465-2473
Number of pages9
JournalJournal of Antimicrobial Chemotherapy
Volume70
Issue number9
DOIs
Publication statusPublished - Sep 2015

Fingerprint

Microbial Drug Resistance
Anti-Bacterial Agents
Patient Compliance
Language
Databases
Delivery of Health Care
Education

Cite this

@article{fa0beda77c3d4bb0bb3b0533bcf79fad,
title = "Not in my backyard: A systematic review of clinicians' knowledge and beliefs about antibiotic resistance",
abstract = "Objectives: To systematically review clinicians' knowledge and beliefs about the importance and causes of antibiotic resistance, and strategies to reduce resistance.Methods: Four databases were searched (until July 2014), without restrictions on language, setting or study design. Fixed responses (from surveys) were grouped into categories. The proportion of participants who agreed with each category was expressed as median, percentage and IQR. Qualitative data were coded into emergent themes. Quantitative categories and qualitative themes were grouped into four overarching categories that emerged from the data.Results: There were 57 included studies (38 quantitative, 14 qualitative, 5 mixed methods) of 11593 clinicians. Most clinicians (69{\%}, IQR 63{\%}-72{\%}, n = 5 studies) had heard of antibiotic resistance and 98{\%} (IQR 93{\%}-99{\%}, n = 5 studies) believed it was serious. The proportion who believed it was a problem for their practice (67{\%}, IQR 65{\%}-74{\%}, n = 13 studies) was smaller than the proportion who believed it was a problem globally (89{\%}, IQR 85{\%}-97{\%}, n = 5 studies) or nationally (92{\%}, IQR 88{\%}-95{\%}, n = 21 studies). Most believed excessive antibiotic use (97{\%}, IQR 91{\%}-98{\%}, n = 12 studies) and patient non-adherence (90{\%}, IQR 82{\%}-92{\%}, n = 7 studies) caused resistance. Most knew of strategies to reduce resistance (e.g. clinician education, 90{\%}, IQR 85{\%}-96{\%}, n = 7 studies). Qualitative findings support these data: they attributed responsibility for antibiotic resistance to patients, other countries and healthcare settings; resistance was considered a low priority and a distant consequence of antibiotic prescribing.Conclusions: Clinicians believe antibiotic resistance is a serious problem, but think it is caused by others. This needs to be accommodated in interventions to reduce antibiotic resistance.",
author = "McCullough, {A. R.} and J. Rathbone and S. Parekh and Hoffmann, {T. C.} and {Del Mar}, {C. B.}",
year = "2015",
month = "9",
doi = "10.1093/jac/dkv164",
language = "English",
volume = "70",
pages = "2465--2473",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "OXFORD UNIV PRESS",
number = "9",

}

Not in my backyard : A systematic review of clinicians' knowledge and beliefs about antibiotic resistance. / McCullough, A. R.; Rathbone, J.; Parekh, S.; Hoffmann, T. C.; Del Mar, C. B.

In: Journal of Antimicrobial Chemotherapy, Vol. 70, No. 9, 09.2015, p. 2465-2473.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Not in my backyard

T2 - A systematic review of clinicians' knowledge and beliefs about antibiotic resistance

AU - McCullough, A. R.

AU - Rathbone, J.

AU - Parekh, S.

AU - Hoffmann, T. C.

AU - Del Mar, C. B.

PY - 2015/9

Y1 - 2015/9

N2 - Objectives: To systematically review clinicians' knowledge and beliefs about the importance and causes of antibiotic resistance, and strategies to reduce resistance.Methods: Four databases were searched (until July 2014), without restrictions on language, setting or study design. Fixed responses (from surveys) were grouped into categories. The proportion of participants who agreed with each category was expressed as median, percentage and IQR. Qualitative data were coded into emergent themes. Quantitative categories and qualitative themes were grouped into four overarching categories that emerged from the data.Results: There were 57 included studies (38 quantitative, 14 qualitative, 5 mixed methods) of 11593 clinicians. Most clinicians (69%, IQR 63%-72%, n = 5 studies) had heard of antibiotic resistance and 98% (IQR 93%-99%, n = 5 studies) believed it was serious. The proportion who believed it was a problem for their practice (67%, IQR 65%-74%, n = 13 studies) was smaller than the proportion who believed it was a problem globally (89%, IQR 85%-97%, n = 5 studies) or nationally (92%, IQR 88%-95%, n = 21 studies). Most believed excessive antibiotic use (97%, IQR 91%-98%, n = 12 studies) and patient non-adherence (90%, IQR 82%-92%, n = 7 studies) caused resistance. Most knew of strategies to reduce resistance (e.g. clinician education, 90%, IQR 85%-96%, n = 7 studies). Qualitative findings support these data: they attributed responsibility for antibiotic resistance to patients, other countries and healthcare settings; resistance was considered a low priority and a distant consequence of antibiotic prescribing.Conclusions: Clinicians believe antibiotic resistance is a serious problem, but think it is caused by others. This needs to be accommodated in interventions to reduce antibiotic resistance.

AB - Objectives: To systematically review clinicians' knowledge and beliefs about the importance and causes of antibiotic resistance, and strategies to reduce resistance.Methods: Four databases were searched (until July 2014), without restrictions on language, setting or study design. Fixed responses (from surveys) were grouped into categories. The proportion of participants who agreed with each category was expressed as median, percentage and IQR. Qualitative data were coded into emergent themes. Quantitative categories and qualitative themes were grouped into four overarching categories that emerged from the data.Results: There were 57 included studies (38 quantitative, 14 qualitative, 5 mixed methods) of 11593 clinicians. Most clinicians (69%, IQR 63%-72%, n = 5 studies) had heard of antibiotic resistance and 98% (IQR 93%-99%, n = 5 studies) believed it was serious. The proportion who believed it was a problem for their practice (67%, IQR 65%-74%, n = 13 studies) was smaller than the proportion who believed it was a problem globally (89%, IQR 85%-97%, n = 5 studies) or nationally (92%, IQR 88%-95%, n = 21 studies). Most believed excessive antibiotic use (97%, IQR 91%-98%, n = 12 studies) and patient non-adherence (90%, IQR 82%-92%, n = 7 studies) caused resistance. Most knew of strategies to reduce resistance (e.g. clinician education, 90%, IQR 85%-96%, n = 7 studies). Qualitative findings support these data: they attributed responsibility for antibiotic resistance to patients, other countries and healthcare settings; resistance was considered a low priority and a distant consequence of antibiotic prescribing.Conclusions: Clinicians believe antibiotic resistance is a serious problem, but think it is caused by others. This needs to be accommodated in interventions to reduce antibiotic resistance.

UR - http://www.scopus.com/inward/record.url?scp=84947253461&partnerID=8YFLogxK

U2 - 10.1093/jac/dkv164

DO - 10.1093/jac/dkv164

M3 - Article

VL - 70

SP - 2465

EP - 2473

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 9

ER -