WHO survey reveals public misunderstanding about antibiotic resistance

Public knowledge about antibiotic resistance is still weak and this is something we should worry about. A new survey conducted in a number of countries shows that people harbour confusion about this major threat to public health and do not understand how to prevent it from increasing.

Sample this for instance. In India, only 58 per cent of respondents know that they should stop taking antibiotics only when they finish the course.

This revelation comes at a time when the World Health Organization (WHO) is scaling up its fight against antibiotic resistance. Antibiotic resistance occurs when bacteria undergo change and become resistant to antibiotics used for treatment of infections. Sometimes, over-use and misuse of antibiotics can increase the development of resistant bacteria.

“The rise of antibiotic resistance is a global health crisis and governments now recognise it as one of the greatest challenges for public health today. It is reaching dangerously high levels in all parts of the world,” Margaret Chan, WHO director-general, said while launching the survey findings on Monday. “Antibiotic resistance is compromising our ability to treat infectious diseases and undermining many advances in medicine.”

The survey

The survey was carried out across 12 countries. Almost two thirds (64 per cent) of around 10,000 people surveyed said that they knew antibiotic resistance was an issue that could affect them and their families, but admitted that how it affected them and what they can do to address it were not well understood.

For instance, 64 per cent of respondents believe that antibiotics can be used to treat common cold and flu, despite the fact that antibiotics have no impact on viruses.  Close to one third (32 per cent) of the people surveyed believe they should stop taking antibiotics when they feel better, rather than completing the prescribed course of treatment.

The survey findings coincide with the launch of a new WHO campaign “Antibiotics: Handle with care”. It is a global initiative to improve understanding of the problem and change the way antibiotics are used. “The findings of this survey point to the urgent need to improve understanding around antibiotic resistance,” Keiji Fukuda, special representative of the director-general for antimicrobial resistance, said.

“This campaign is just one of the ways we are working with governments, health authorities and other partners to reduce antibiotic resistance. One of the biggest health challenges of the 21st century will require global behaviour change by individuals and societies.”

The multi-country survey included 14 questions on the use of antibiotics, knowledge of antibiotics and antibiotic resistance. It used a mix of online and face-to-face interviews.

The survey was conducted in Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, the Russian Federation, Serbia, South Africa, Sudan and Vietnam.

Common misconceptions

The survey shows how ignorance or lack of sufficient knowledge leads to popular misconception about antibiotic resistance. About 76 per cent of the respondents think that antibiotic resistance happens when the body becomes resistant to antibiotics. They think that bacteria—not humans and animals—become resistant to antibiotics and their spread causes infections.

Around 66 per cent of the respondents think that individuals are not at risk of a drug-resistant infection if they personally take their antibiotics as prescribed. More than half 57 per cent of respondents feel there is not much they can do to stop antibiotic resistance while nearly 64 per cent believe that medical experts will solve the problem before it becomes too serious.

A key finding of the survey was that almost 73 per cent of respondents said that farmers should give fewer antibiotics to food-producing animals.  To address the growing problem of antibiotic resistance, a global action plan to tackle it was endorsed at the World Health Assembly in May 2015. One of the objective is to improve awareness and understanding of antibiotic resistance through effective communication, education and training.

Key findings in some of the countries

In China,1,002 online interviews were cconducted and these are the results:

• About 57 per cent of respondents report taking antibiotics within the past six months; 74 per cent say they were prescribed or provided by a doctor or nurse; 5 per cent say they purchased them on the internet.
• Over 53 per cent of respondents wrongly believe that they should stop taking antibiotics when they feel better, rather than taking the full course as directed.
• Sixty-one per cent of respondents think, incorrectly, that colds and flu can be treated by antibiotics.
• Sixty-seven per cent of respondents are familiar with the term “antibiotic resistance” and 75 per cent said it is “one of the biggest problems in the world”.
• About 83 per cent of respondents say that farmers should give fewer antibiotics to animals—the highest proportion of any country in the survey. 

 In India, 1,023 online interviews were carried out to know about the public stand on antibiotic resistance. Some of the key findings are as follows:

• More than 76 per cent of respondents report having taken antibiotics within the past six months; 90 per cent say they were prescribed or provided by a doctor or nurse.
• About 75 per cent of respondents think, incorrectly, that colds and flu can be treated with antibiotics.
• While 75 per cent agree that antibiotic resistance is one of the biggest problems in the world, 72 per cent of respondents believe experts will solve the problem before it becomes too serious.

 In Mexico,1,001 online interviews were taken and these are the findings:

• Seventy-five per cent of respondents report having taken antibiotics within the past six months; 92 per cent say they were prescribed by a doctor or nurse; and 97 per cent say they got them from a pharmacy or medical store.
• The majority of respondents (83 per cent) accurately identify that bladder/urinary tract infections can be treated with antibiotics, but 61 per cent wrongly believe that colds and flu can be treated with antibiotics.
• Eighty-nine per cent of respondents in Mexico say they have heard of the term “antibiotic resistance” and 84 per cent believe many infections are becoming increasingly resistant to treatment by antibiotics—a higher proportion than any other country included in the survey on both questions.

 In South Africa, 1,002 online interviews were conducted and the folowing things were found:

• Sixty-five per cent of respondents say they have taken antibiotics within the past six months; a higher proportion of people than any other country included in the survey, 93 per cent say their last course of antibiotics was prescribed or provided by a doctor or nurse and 95 per cent say they had advice from a medical professional on how to take them.
• Eighty-seven per cent of respondents know they should only stop taking antibiotics when they finish the course of treatment.