Factors determining antibiotic use in the general population: A qualitative study in Spain

PLoS One. 2021 Feb 4;16(2):e0246506. doi: 10.1371/journal.pone.0246506. eCollection 2021.

Abstract

Background: Antibiotic resistance is an important Public Health problem and many studies link it to antibiotic misuse. The population plays a key role in such misuse.

Objective: The aim of this study was thus to explore the factors that might influence antibiotic use and resistance in the general population.

Methods: Qualitative research using the focus group (FG) method. Groups were formed by reference to the following criteria: age (over and under 65 years); place of origin; and educational/professional qualifications. FG sessions were recorded, transcribed and then separately analysed by two researchers working independently. Written informed consent was obtained from all participants.

Results: Eleven FGs were formed with a total of 75 participants. The principal factors identified as possible determinants of antibiotic misuse were: (i) lack of knowledge about antibiotics; (ii) doctor-patient relationship problems; (iii) problems of adherence; and, (iv) use without medical prescription. Antibiotic resistance is a phenomenon unknown to the population and is perceived as an individual problem, with the term "resistance" being confused with "tolerance". None of the groups reported that information about resistance had been disseminated by the health care sector.

Conclusions: The public is unaware of the important role it plays in the advance of antimicrobial resistance. There is evidence of diverse factors, many of them modifiable, which might account for antibiotic misuse. Better understanding these factors could be useful in drawing up specific strategies aimed at improving antibiotic use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Microbial
  • Female
  • Focus Groups
  • Humans
  • Male
  • Public Health / methods
  • Spain

Substances

  • Anti-Bacterial Agents

Grants and funding

This work was supported in part by the Instituto de Salud Carlos III (PI081239, PI09/90609) Spanish State Plan for Scientific and Technical Research and Innovation 2012-2016, The European Regional Development Fund (ERDF). https://www.isciii.es/QueHacemos/Financiacion/Paginas/default.aspx.