Antibiotic intake and resistance development - Knowledge, experience and behavior among the German general population

The network project RAI (Rational Use of Antibiotics via Information and Communication) is aimed at developing tailored information and communication tools on the subject of antibiotic (AB) resistance for various stakeholder groups. During the preparation phase, a survey was performed addressing the German general population. To gain insights into the knowledge, attitudes, and behavior of nonprescribers concerning AB and multidrug-resistant organisms (MDRO). Using computer-assisted, telephone-based interviews a random sample of 1,004 persons aged 14 years and older was surveyed. Descriptive reporting of data and multivariate analysis were performed, including sociodemographic variables. Only 24 % of participants knew that bacteria (but not viruses or humans) could develop AB resistance. However, this knowledge did not influence the outcome of other questions. Regardless of knowledge, 71 % thought that the subject was important, but 58 % did not believe in the influence of their own behavior on MDRO development. When visiting a physician, patients were given an antibiotic three times as often as information on AB resistance. 17 % did not take the AB as prescribed and 20 % of all participants stated that they personally knew at least one person with MDRO problems. This personal involvement had a significant effect on the rating of self-influence, on the importance of the subject, on the interaction between patient and physician (more information, less AB), and on AB intake compliance (less frequent). We found considerable knowledge gaps, but this had no impact on the assessment of the subject. A starting point for an intervention could be patient-physician communication. This seems more effective and safer than a public campaign.