16 November 2015 ǀ GENEVA – As the World Health Organization (WHO) ramps up its fight against antibiotic resistance, a new multi-country survey shows people are confused about this major threat to public health and do not understand how to prevent it from growing. 

Antibiotic resistance happens when bacteria change and become resistant to the antibiotics used to treat the infections they cause. Over-use and misuse of antibiotics increase the development of resistant bacteria, and this survey points out some of the practices, gaps in understanding and misconceptions which contribute to this phenomenon. 

Almost two thirds (64%) of some 10 000 people who were surveyed across 12 countries say they know antibiotic resistance is an issue that could affect them and their families, but how it affects them and what they can do to address it are not well understood. For example, 64% of respondents believe antibiotics can be used to treat colds and flu, despite the fact that antibiotics have no impact on viruses. Close to one third (32%) of people surveyed believe they should stop taking antibiotics when they feel better, rather than completing the prescribed course of treatment. 

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

The survey findings coincide with the launch of a new WHO campaign ‘Antibiotics: Handle with care’—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,” says Dr Keiji Fukuda, Special Representative of the Director-General for Antimicrobial Resistance. “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 of antibiotic resistance, and used a mix of online and face-to-face interviews. It was conducted in 12 countries: Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, the Russian Federation, Serbia, South Africa, Sudan and Viet Nam. While not claiming to be exhaustive, this and other surveys will help WHO and partners to determine the key gaps in public understanding of this problem and misconceptions about how to use antibiotics to be addressed through the campaign. 

Some common misconceptions revealed by the survey include:

        Three quarters (76%) of respondents think that antibiotic resistance happens when the body becomes resistant to antibiotics. In fact bacteria—not humans or animals—become resistant to antibiotics and their spread causes hard-to-treat infections.
        Two thirds (66%) of respondents believe that individuals are not at risk of a drug-resistant infection if they personally take their antibiotics as prescribed. Nearly half (44%) of people surveyed think antibiotic resistance is only a problem for people who take antibiotics regularly. In fact, anyone, of any age, in any country can get an antibiotic-resistant infection.
        More than half (57%) of respondents feel there is not much they can do to stop antibiotic resistance, while nearly two thirds (64%) believe medical experts will solve the problem before it becomes too serious.
Another key finding of the survey was that almost three quarters (73%) of respondents say farmers should give fewer antibiotics to food-producing animals. 

To address this growing problem, a global action plan to tackle antimicrobial resistance was endorsed at the World Health Assembly in May 2015. One of the plan’s five objectives is to improve awareness and understanding of antibiotic resistance through effective communication, education and training. 

KEY FINDINGS OF THE SURVEY FROM SOUTH AFRICA 

South Africa (1,002 online interviews)

65% 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%) say their last course of antibiotics was prescribed or provided by a doctor or nurse, and 95% say they had advice from a medical professional on how to take them.
87% of respondents know they should only stop taking antibiotics when they finish the course of treatment—a higher proportion than any other country included in the survey.
The same proportion (87%) of respondents—and again more than any other country in the survey—recognize that the statement ‘It’s OK to use antibiotics that were given to a friend of family member, as long as they were used to treat the same illness’ is false. It is a practice which can encourage the development of resistance.
About the survey

The multi-country survey was limited to two countries per WHO Region, 12 countries overall. Data cannot be considered to be representative of each Region, nor of the global situation. Fieldwork was carried out by research agency 2CV between 14 September and 16 October 2015. A total of 9,772 respondents completed the 14 question survey either online or during a face-to-face street interview.

About the ‘Antibiotics: Handle with care’ campaign:

WHO is launching a global campaign, ‘Antibiotics: Handle with care’, during the first World Antibiotic Awareness Week, 16-22 November 2015. The aim of the campaign is to raise awareness and encourage best practices among the public, policymakers, health and agriculture professionals to avoid the further emergence and spread of antibiotic resistance. 

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Olivia Lawe-Davies

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