Methods: We developed and tested a 13-item instrument asking participants about their beliefs and knowledge that conceptualize appropriate antibiotic use. A single free-text question asked respondents to explain in their own words the meaning of antibiotic resistance. Respondents were recruited with the Amazon Mechanical Turk crowdsourcing platform. Survey outcomes were evaluated for reliability and validity.
Results: Among 215 respondents, the average age was 37 years (± 12 years), and 72% were college educated. The majority of respondents agreed that inappropriate antibiotic use contributes to antibiotic resistance (92%), that they did not keep leftover antibiotics (82%) and that consumption of livestock treated with antibiotics affects humans (92%). Almost half of the respondents (47%) responded neutrally to the statement that antibiotic resistance is a problem. Dominant themes from the free-text response were that 1) antibiotic resistance involves an immune response by the host against an antibiotic, 2) resistance represents a reduction in antibiotic power or strength and, 3) resistance is a consequence of antibiotic exposure. A fourth theme revealed confusion about the following clinical terms: bacteria, viruses, antibodies, resistance and immunity.
Conclusion: Our findings indicate that the public is aware that antibiotic misuse contributes to antibiotic resistance but many do not consider it to be an important problem. The free-text responses suggest specific educational targets, including the difference between viruses and bacteria, to increase public awareness of antibiotic resistance.
R. Jump, Pfeizer: Investigator , Educational grant
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