Abstract
ObjectivesKnowledge concerning antibiotic use in the general population is insufficient. The way health literacy is related to antibiotic use aside from knowledge needs further investigation. Our aim was to compare the levels of knowledge of antibiotics and health literacy in individuals who had taken antibiotics in recent years compared with those who not had taken antibiotics.MethodsA population-based cross-sectional survey of 2,000 individuals aged 35 and older from Berlin, Germany and its surrounding rural and suburban areas (response rate 59%) with strata urban/rural, sex, age, and education. Computer-assisted personal interviews were conducted by external, trained interviewers during home visits. Knowledge, health literacy, and antibiotic use were assessed using standardized questionnaires.ResultsIn all, 33.3% (666/2,000) of the participants indicated having had an antimicrobial therapy during the previous 12 months. Adjusting for sex, age, educational level and health literacy, individuals with four correct answers regarding antibiotics were 1.70 times and those with three correct answers 1.94 more likely to have had a history of recent antibiotic use than those who did not have any correct answers. Individuals with sufficient health literacy were 0.57 times less likely to have had a recent history of antibiotic use than individuals with insufficient health literacy.ConclusionPatients who have used antibiotics might have more knowledge as a result of their recent involvement with the topic of antibiotic use; health literacy may be a preventive mechanism to use antibiotics more critically. Besides improving the health knowledge of the general population and of vulnerable groups such as patients with low levels of health literacy, intervention strategies should focus on providers as well.
Highlights
The rise of drug-resistant organisms poses a challenge for modern medicine [1]
Adjusting for sex, age, educational level and health literacy, individuals with four correct answers regarding antibiotics were 1.70 times and those with three correct answers 1.94 more likely to have had a history of recent antibiotic use than those who did not have any correct answers
Individuals with sufficient health literacy were 0.57 times less likely to have had a recent history of antibiotic use than individuals with insufficient health literacy
Summary
The rise of drug-resistant organisms poses a challenge for modern medicine [1]. Antimicrobial resistance is a natural phenomenon [2], but it exacerbated with antimicrobial exposure [3,4]. Many primary care physicians feel pressured by their patients to prescribe antibiotics for infections which do not necessarily require antibiotics–i.e., pressured by patients who are not fully aware of the difference between viral and bacterial infections, for example, influenza, colds or sore throat [11,12]. Knowledge of the mode of action of antibiotics in the general population is insufficient in Europe as much as it is in Germany. This may have detrimental effects on prescription and intake routines [13,14]. Low health literacy has been shown to be associated with inappropriate use of the health care system [18]. Health literacy influences patient-provider relationship, self-care and the use of the health care system [20]
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