‘I don’t know if we can really, really change that’: a qualitative exploration of public perception towards antibiotic resistance in France

Abstract

Background Since the 2000s, French authorities have put in place various national plans to make the general public aware of antibiotic stewardship. Twenty years later, France is still one of the countries with the highest use of antibiotics in Europe. Objectives Our study explored the general public’s perceptions of antibiotic resistance, their behaviour around antibiotic use and their expectations regarding awareness campaigns. Methods A qualitative study was performed from March 2018 to March 2019 in a French region using focus groups. Two types of public were targeted: parents of young children and retired people. The interview guide contained open-ended questions organized around three main themes: perceptions of antibiotic resistance; experience and use of antibiotics; and health information and campaigns. Results Nine focus groups were created, including 17 parents and 19 retirees. Participants did not link antibiotic overuse and antibiotic resistance. Antibiotic resistance was not perceived as a personal responsibility but as a suffered phenomenon on which the participants could not act. The blame was particularly put on the presence of antibiotics in the environment. Although participants expressed trust in their GPs, antibiotics remained perceived as the only solution for them to be cured quickly. Conclusions The study highlighted that the GPs were the preferred information source regarding the use of antibiotics. Actions targeting the public and health professionals will have little impact if, at the same time, efforts on work environment representation are not undertaken.

Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

“…The normative role of individuals' social circle, mainly friends and families, was recognized also by Westerling et al [51]. With regards to the notion of responsibility for ABR, a notable difference was detected with the findings from Essilini et al [52]. The French focus group participants did not perceive ABR as a personal responsibility.…”

“…Some comparisons can be made with similar studies performed in other countries with relatively high rates of antibiotic use and antibiotic resistance in the WHO European region [49]. The centrality of trust in health professionals and health institutions as a factor promoting a judicious use of antibiotics -and conversely, lack of trust as a hindering factor -was emphasized by recent research on the Spanish, Turkish, and French public [50][51][52]. In contrast to the findings of the present study, participants in focus groups in Spain showed a relative lack of knowledge and a lack of perception of the problem of antibiotic resistance [50].…”

French general practitioners’ and patients’ acceptability of a public commitment charter and patient information leaflets targeting unnecessary antibiotic use: a qualitative study

“…Patients often do not distinguish between viral and bacterial infections, and believe that the perceived severity of an infection justifies an antibiotic treatment [ 9 , 11 , 25 , 26 ]. Besides, patients’ demand for antibiotics (real and/or perceived by doctors) is a well-known reason for unnecessary antibiotic prescribing, especially for respiratory tract infections [ 10 , 27 , 28 ].…”

“…Among antibiotic stewardship interventions, many educational interventions targeting prescribers have been studied, with heterogeneous results and a relatively low quality of evidence [ 8 ]. As patients may exert pressure on prescribers to get antibiotics, education should target not only prescribers but also patients [ 9 – 12 ]. However, few interventions targeting both of them have been conducted, with contradictory findings [ 5 , 13 , 14 ].…”

Community pharmacists’ views on their current role and future opportunities for antibiotic stewardship: a French qualitative study

“…Some patients may keep leftovers and self-medicate or share their antibiotics with relatives. 19 , 31 Patients are however encouraged to return unused drugs (including antibiotics) to their pharmacist for safe disposal through the French system for retrieving and disposing of unused drugs called Cyclamed ® , in place since 1993 (this system does not include any incentive for patients). 32…”