Comment on: A systematic review of the public's knowledge and beliefs about antibiotic resistance.

Abstract

Sir, We read with interest the article by McCullough et al. presenting the results of their systematic review of quantitative and qualitative studies on the public’s knowledge and beliefs about antibiotic resistance and antibiotics. The review included information from four major databases (MEDLINE, EMBASE, PsycINFO and CINAHL) without restrictions about study design or language, as well as forward and backward citation in Web of Science and Scopus. However, the review omitted two very large-size special Eurobarometer surveys performed by the European Commission in 2009 and 2013, which we think would be relevant to bring to your readers’ attention. Eurobarometer surveys aim to monitor the evolution of opinion of the public in the European Union (EU). Standard Eurobarometer surveys are performed two to five times a year for the European Commission by TNS Opinion & Social Network following a multistage random sampling design in each EU Member State. Special Eurobarometer surveys explore specific topics and are included as part of the polling waves for the standard Eurobarometer surveys. A special Eurobarometer survey on antimicrobial resistance was performed in November–December 2009 and included four questions on the knowledge of Europeans about antibiotics. In each EU Member State at least 1000 face-to-face interviews were performed (with the exception of Cyprus, Luxembourg and Malta, where at least 500 interviews were carried out in each country), making a total of 27000 interviews. As part of its Action Plan Against The Rising Threats From Antimicrobial Resistance, the European Commission conducted a second special Eurobarometer survey on antimicrobial resistance in May–June 2013 using the same questions. Overall, the percentage of Europeans that reported having taken an antibiotic orally during the 12 months preceding the survey decreased from 40% in 2009 to 35% in 2013. The results regarding public knowledge about antibiotics, overall for the EU as well as for each individual Member State, are compiled in Table 1. While differences in percentages observed for the EU overall between 2009 and 2013 are statistically significant due to the large sample size, differences observed for each individual Member State must be interpreted with caution, taking into account the indicative statistical margins provided in an annex to the report. There was an increase between 2009 and 2013 in the proportion of people who responded that antibiotics do not kill viruses and are not effective against cold and flu. This is encouraging since the key messages of European Antibiotic Awareness Day, which was relayed