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Article

Awareness of Appropriate Antibiotic Use in Primary Care for Influenza-Like Illness: Evidence of Improvement from UK Population-Based Surveys

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Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford OX1 2JD, UK
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NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
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Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
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Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Primary Care and Interventions Unit, Public Health England, Gloucester GL1 1DQ, UK
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School of Health Sciences, Division of Nursing, University of London, London EC1V 0HB, UK
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Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
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Oxford University Hospitals NHS Trust, Oxford OX3 9DU, UK
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Modelling and Economics Unit, National Infection Service, Public Health England, London NW9 5EQ, UK
*
Author to whom correspondence should be addressed.
Contribution considered equal and listed alphabetically.
Antibiotics 2020, 9(10), 690; https://doi.org/10.3390/antibiotics9100690
Received: 29 August 2020 / Revised: 2 October 2020 / Accepted: 10 October 2020 / Published: 13 October 2020
(This article belongs to the Special Issue Antimicrobial Stewardship in Primary Care)
Influenza-like illnesses (ILI) account for a significant portion of inappropriate antibiotic use. Patient expectations for antibiotics for ILI are likely to play a substantial role in ‘unnecessary’ antibiotic consumption. This study aimed to investigate trends in awareness of appropriate antibiotic use and antimicrobial resistance (AMR). Three sequential online surveys of independent representative samples of adults in the United Kingdom investigated expectations for, and consumption of, antibiotics for ILI (May/June 2015 (n = 2064); Oct/Nov 2016 (n = 4000); Mar 2017 (n = 4000)). Respondents were asked whether they thought antibiotics were effective for ILI and about their antibiotic use. Proportions and 95% confidence intervals (CI) were calculated for each question and interactions with respondent characteristics were tested using logistic regression. Over the three surveys, the proportion of respondents who believed antibiotics would “definitely/probably” help an ILI fell from 37% (95% CI 35–39%) to 28% (95% CI 26–29%). Those who would “definitely/probably” visit a doctor in this situation fell from 48% (95% CI 46–50%) to 36% (95% CI 34–37%), while those who would request antibiotics during a consultation fell from 39% (95% CI 37–41%) to 30% (95% CI 29–32%). The percentage of respondents who found the information we provided about AMR “new/surprising” fell from 34% (95% CI 32–36%) to 28% (95% CI 26–31%). Awareness improved more among black, Asian and minority ethnic (BAME) than white people, with little other evidence of differences in improvements between subgroups. Whilst a degree of selection bias is unavoidable in online survey samples, the results suggest that awareness of AMR and appropriate antibiotic use has recently significantly improved in the United Kingdom, according to a wide range of indicators. View Full-Text
Keywords: antibiotics; antimicrobial resistance; survey antibiotics; antimicrobial resistance; survey
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MDPI and ACS Style

Pouwels, K.B.; Roope, L.S.J.; Buchanan, J.; Morrell, L.; Tonkin-Crine, S.; Peters, M.; Jones, L.F.; Castro-Sánchez, E.; Crook, D.W.; Peto, T.; Butler, C.C.; Robotham, J.V.; Walker, A.S.; Wordsworth, S. Awareness of Appropriate Antibiotic Use in Primary Care for Influenza-Like Illness: Evidence of Improvement from UK Population-Based Surveys. Antibiotics 2020, 9, 690. https://doi.org/10.3390/antibiotics9100690

AMA Style

Pouwels KB, Roope LSJ, Buchanan J, Morrell L, Tonkin-Crine S, Peters M, Jones LF, Castro-Sánchez E, Crook DW, Peto T, Butler CC, Robotham JV, Walker AS, Wordsworth S. Awareness of Appropriate Antibiotic Use in Primary Care for Influenza-Like Illness: Evidence of Improvement from UK Population-Based Surveys. Antibiotics. 2020; 9(10):690. https://doi.org/10.3390/antibiotics9100690

Chicago/Turabian Style

Pouwels, Koen B., Laurence S.J. Roope, James Buchanan, Liz Morrell, Sarah Tonkin-Crine, Michele Peters, Leah F. Jones, Enrique Castro-Sánchez, Derrick W. Crook, Tim Peto, Christopher C. Butler, Julie V. Robotham, A. S. Walker, and Sarah Wordsworth. 2020. "Awareness of Appropriate Antibiotic Use in Primary Care for Influenza-Like Illness: Evidence of Improvement from UK Population-Based Surveys" Antibiotics 9, no. 10: 690. https://doi.org/10.3390/antibiotics9100690

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