Decision making about antibiotic use: examining the role of antibiotic resistance knowledge, concern, and previous inappropriate antibiotic use

Abstract

ABSTRACTAntibiotic resistance has become a major public health threat due, in part, to inappropriate antibiotic use. The aim of the present study was to examine the role of antibiotic resistance knowledge, concern, and previous antibiotic misuse in decision making about antibiotic use. Participants (n = 548) recruited through Amazon Mechanical Turk were asked to read four hypothetical scenarios about health conditions (head cold, urinary tract infection, leg wound and respiratory infection). They responded to each scenario regarding their likelihood of engaging in antibiotic use behaviors including (a) whether they would seek an antibiotic prescription from a physician, and (b) whether they would take old antibiotics. Participants also completed questions regarding their knowledge and concern about antibiotic resistance, and previous antibiotic use. Logistic regressions were employed to examine the role of previous antibiotic use for the cold or flu, antibiotic resistance knowledge, and antibiotic resistance concern in the likelihood of antibiotic use. The three variables were predictive of both appropriate and inappropriate antibiotic use in relation to the hypothetical scenarios. Individual-level factors play a role in decision making about antibiotic use. In addressing the issue of antibiotic resistance, it will be necessary to not only increase antibiotic resistance knowledge in the general population, but also to increase antibiotic resistance concern. Past inappropriate antibiotic use should also be considered a risk factor for future antibiotic misuse; therefore, both broad public health campaigns and individually-tailored programs (e.g. in appointments at doctors’ offices) should be considered in curbing inappropriate antibiotic use.