Ashiru-Oredope Diane, Casale Ella, Harvey Eleanor, Umoh Eno, Vasandani Sagar, Reilly Jacqui, Hopkins Susan
HCAI, Fungal, AMR, AMU & Sepsis Division, United Kingdom Health Security Agency, London SW1P 3JR, UK.
NHS National Services Scotland, Edinburgh EH12 9EB, UK.
Antibiotics (Basel). 2022 Aug 21;11(8):1133. doi: 10.3390/antibiotics11081133.
Using the COM-B model as a framework, an EU-wide survey aimed to ascertain multidisciplinary healthcare workers' (HCWs') knowledge, attitudes and behaviours towards antibiotics, antibiotic use and antibiotic resistance. The UK findings are presented here.
A 43-item questionnaire was developed through a two-round modified Delphi consensus process. The UK target quota was 1315 respondents.
In total, 2404 participants responded. The highest proportion were nursing and midwifery professionals (42%), pharmacists (23%) and medical doctors (18%). HCWs correctly answered that antibiotics are not effective against viruses (97%), they have associated side effects (97%), unnecessary use makes antibiotics ineffective (97%) and healthy people can carry antibiotic-resistant bacteria (90%). However, fewer than 80% correctly answered that using antibiotics increases a patient's risk of antimicrobial resistant infection or that resistant bacteria can spread from person to person. Whilst the majority of HCWs (81%) agreed there is a connection between their antibiotic prescribing behaviour and the spread of antibiotic-resistant bacteria, only 64% felt that they have a key role in controlling antibiotic resistance. The top three barriers to providing advice or resources were lack of resources (19%), insufficient time (11%) and the patient being uninterested in the information (7%). Approximately 35% of UK respondents who were prescribers prescribed an antibiotic at least once in the previous week to responding to the survey due to a fear of patient deterioration or complications.
These findings highlight that a multifaceted approach to tackling the barriers to prudent antibiotic use in the UK is required and provides evidence for guiding targeted policy, intervention development and future research. Education and training should focus on patient communication, information on spreading resistant bacteria and increased risk for individuals.
以COM-B模型为框架，一项全欧盟范围的调查旨在确定多学科医护人员对抗生素、抗生素使用及抗生素耐药性的知识、态度和行为。本文展示了英国的调查结果。
通过两轮改良德尔菲共识流程制定了一份包含43个条目的问卷。英国的目标配额是1315名受访者。
共有2404名参与者做出回应。比例最高的是护理和助产专业人员（42%）、药剂师（23%）和医生（18%）。医护人员正确回答了抗生素对病毒无效（97%）、它们有相关副作用（97%）、不必要的使用会使抗生素失效（97%）以及健康人可携带耐抗生素细菌（90%）。然而，正确回答使用抗生素会增加患者发生抗菌药物耐药感染风险或耐药细菌可在人与人之间传播的比例不到80%。虽然大多数医护人员（81%）同意他们的抗生素处方行为与抗生素耐药细菌的传播之间存在关联，但只有64%的人认为他们在控制抗生素耐药性方面发挥关键作用。提供建议或资源的三大障碍是缺乏资源（19%）、时间不足（11%）和患者对信息不感兴趣（7%）。在英国，约35%的开处方受访者因担心患者病情恶化或出现并发症，在参与调查的前一周至少开具过一次抗生素。
这些发现凸显了在英国需要采取多方面方法来应对谨慎使用抗生素的障碍，并为指导针对性政策、干预措施制定及未来研究提供了证据。教育和培训应侧重于与患者沟通、关于耐药细菌传播的信息以及个人风险增加方面。
