Pouwels Koen B, Roope Laurence S J, Buchanan James, Morrell Liz, Tonkin-Crine Sarah, Peters Michele, Jones Leah F, Castro-Sánchez Enrique, Crook Derrick W, Peto Tim, Butler Christopher C, Robotham Julie V, Walker A Sarah, Wordsworth Sarah
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
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.
Antibiotics (Basel). 2020 Oct 13;9(10):690. doi: 10.3390/antibiotics9100690.
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 ( = 2064); Oct/Nov 2016 ( = 4000); Mar 2017 ( = 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.
流感样疾病（ILI）占不适当使用抗生素情况的很大一部分。患者对ILI使用抗生素的期望很可能在“不必要的”抗生素消费中起重要作用。本研究旨在调查适当使用抗生素和抗菌药物耐药性（AMR）的认知趋势。对英国成年人独立代表性样本进行了三项连续的在线调查，调查了对ILI使用抗生素的期望和消费情况（2015年5月/6月（n = 2064）；2016年10月/11月（n = 4000）；2017年3月（n = 4000））。询问受访者他们是否认为抗生素对ILI有效以及他们的抗生素使用情况。对每个问题计算比例和95%置信区间（CI），并使用逻辑回归测试与受访者特征的相互作用。在这三项调查中，认为抗生素“肯定/可能”有助于治疗ILI的受访者比例从37%（95%CI 35 - 39%）降至28%（95%CI 26 - 29%）。在这种情况下“肯定/可能”会去看医生的受访者比例从48%（95%CI 46 - 50%）降至36%（95%CI 34 - 37%），而在咨询期间会要求使用抗生素的受访者比例从39%（95%CI 37 - 41%）降至30%（95%CI 29 - 32%）。认为我们提供的关于AMR的信息“新颖/令人惊讶”的受访者比例从34%（95%CI 32 - 36%）降至28%（95%CI 26 - 31%）。黑人、亚洲人和少数族裔（BAME）人群的认知改善比白人更多，几乎没有其他证据表明亚组之间在改善方面存在差异。虽然在线调查样本中不可避免地存在一定程度的选择偏差，但结果表明，根据一系列指标，英国最近对AMR和适当使用抗生素的认知有了显著改善。
