South East Wales Trials Unit, Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, Wales, UK.
J Gen Intern Med. 2012 Jul;27(7):766-72. doi: 10.1007/s11606-011-1916-1. Epub 2011 Nov 8.
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.
To explore patients' interpretations of 'antibiotic resistance' and to consider the implications for strategies to contain antibiotic resistance.
Multi country qualitative interview study.
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).
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.
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.
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.
促进基于证据的抗生素处方和使用的干预措施通常基于抗生素耐药性的概念，但患者和临床医生可能对其含义没有相同的假设。
探讨患者对“抗生素耐药性”的理解，并考虑其对控制抗生素耐药性策略的影响。
多国定性访谈研究。
来自九个欧洲国家的初级保健研究网络的 121 名成年患者，他们最近因下呼吸道感染（LRTI）症状咨询了初级保健临床医生。
对患者进行半结构化访谈，在咨询后进行，并采用五阶段分析框架方法（熟悉、从访谈问题和数据中出现的主题构建主题框架、索引、图表、映射以寻找数据中的解释），由当地网络协调员对初步报告发表评论。
主导主题是抗生素耐药性作为“耐药人体”的一种特性，抗生素有效性的障碍是个体失去反应性。较少见的是，患者正确地将抗生素耐药性概念化为细菌的一种特性。然而，几乎所有患者的解释中都有一个强烈的核心概念，即抗生素的过度使用，无论他们是将耐药性视为存在于身体还是细菌中。
大多数患者都意识到抗生素使用与抗生素耐药性之间的联系。对将抗生素耐药性错误地解释为人体而不是细菌细胞的特性的识别，可以通过强调耐药性的可转移性以及个人通过更适当的抗生素处方和使用可以做出的社会贡献，为更清晰的医患讨论和公共卫生干预提供信息。
