Journal of General Internal Medicine

, Volume 27, Issue 7, pp 766–772

‘The Body Gets Used to Them’: Patients’ Interpretations of Antibiotic Resistance and the Implications for Containment Strategies

Authors

    • South East Wales Trials Unit (SEWTU), Department of Primary Care and Public Health, School of MedicineCardiff University
  • Glyn Elwyn
    • Department of Primary Care and Public Health, School of MedicineCardiff University
  • Kerenza Hood
    • South East Wales Trials Unit (SEWTU), Department of Primary Care and Public Health, School of MedicineCardiff University
  • Fiona Wood
    • Department of Primary Care and Public Health, School of MedicineCardiff University
  • Lucy Cooper
    • Health Research, Institute of Psychology, Health & SocietyUniversity of Liverpool
  • Herman Goossens
    • University of Antwerp-Campus, Drie Eiken, Vaccine & Infectious Disease Institute - Laboratory of Medical MicrobiologyUniversity Hospital Antwerp
  • Margareta Ieven
    • University of Antwerp-Campus, Drie Eiken, Vaccine & Infectious Disease Institute - Laboratory of Medical MicrobiologyUniversity Hospital Antwerp
  • Christopher C Butler
    • Department of Primary Care and Public Health, School of MedicineCardiff University
Original Research

DOI: 10.1007/s11606-011-1916-1

Cite this article as:
Brookes-Howell, L., Elwyn, G., Hood, K. et al. J GEN INTERN MED (2012) 27: 766. doi:10.1007/s11606-011-1916-1

Abstract

BACKGROUND

Interventions promoting evidence based antibiotic prescribing and use frequently build on the concept of antibiotic resistance but patients and clinicians may not share the same assumptions about its meaning.

OBJECTIVE

To explore patients’ interpretations of ‘antibiotic resistance’ and to consider the implications for strategies to contain antibiotic resistance.

DESIGN

Multi country qualitative interview study.

PARTICIPANTS

One hundred and twenty-one adult patients from primary care research networks based in nine European countries who had recently consulted a primary care clinician with symptoms of Lower Respiratory Tract Infection (LRTI).

APPROACH

Semi-structured interviews with patients following their consultation and subjected to a five-stage analytic framework approach (familiarization, developing a thematic framework from the interview questions and the themes emerging from the data, indexing, charting, and mapping to search for interpretations in the data), with local network facilitators commenting on preliminary reports.

RESULTS

The dominant theme was antibiotic resistance as a property of a ‘resistant human body’, where the barrier to antibiotic effectiveness was individual loss of responsiveness. Less commonly, patients correctly conceptualized antibiotic resistance as a property of bacteria. Nevertheless, the over-use of antibiotics was a strong central concept in almost all patients’ explanations, whether they viewed resistance as located in either the body or in bacteria.

CONCLUSIONS

Most patients were aware of the link between antibiotic use and antibiotic resistance. The identification of the misinterpretation of antibiotic resistance as a property of the human body rather than bacterial cells could inform clearer clinician–patient discussions and public health interventions through emphasising the transferability of resistance, and the societal contribution individuals can make through more appropriate antibiotic prescribing and use.

KEY WORDS

antibiotic resistanceprimary health carequalitative researchpatient beliefs

Copyright information

© Society of General Internal Medicine 2011