Survey: Global public confused on antimicrobials

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World Health Organization survey results show confusion worldwide on how antimicrobials should be used and why drug resistance develops.

Only 70 percent of those surveyed reported having heard the term “antibiotic resistance.”

Also, of the 9,800 respondents from 12 countries, 65 percent reported having taking antibiotics in the previous six months, with more frequent use among residents of countries with lower incomes and among younger respondents, according to a WHO report published Nov. 16, 2015, at the start of the WHO-sponsored World Antibiotic Awareness Week. The U.S. Department of Agriculture and Centers for Disease Control and Prevention are among participants in the campaign.

The survey responses—a mix of online and in-person responses—came from residents of Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, Russia, Serbia, South Africa, Sudan, and Vietnam. The WHO selected the counties to provide for variety in region, income, and population size, among other factors, according to the report.

Almost one-third of those surveyed by the WHO thought they should stop taking antibiotics when they felt better, with more than half of those surveyed from China, Egypt, and Sudan agreeing with that position. And two-thirds of respondents thought antimicrobials could be used to treat influenza and similar viral illnesses.

The responses also indicate 57 percent of those surveyed think they can do little to stop antimicrobial resistance from developing.

“This is concerning, as addressing the problem of antibiotic resistance in fact requires action from everyone, from members of the public and policy makers, to health and agricultural professionals,” the report states.

Yet, about 90 percent of those surveyed agreed that regular hand-washing would help mitigate the risk of resistance, and almost as many agreed doctors should prescribe antimicrobials only when needed.

Those surveyed were more likely to acknowledge actions that could be taken by others, with about 75 percent each indicating farmers should give fewer antimicrobials to animals, and governments should reward the development of new antimicrobials.

Bar chart: Survey results on recent antimicrobial use, by country
This graph shows responses (expressed as percentages of respondents) to the survey question “When did you last take antibiotics?” It was in the World Health Organization report “Antibiotic resistance: multi-country public awareness survey.” (Courtesy of the World Health Organization. Colors modified for clarity.)

The WHO is trying to raise awareness about the risks of antimicrobial resistance and urge use of best practices by the public, policymakers, and those working in medicine and agriculture. That campaign is part of the WHO’s global action plan on antimicrobial resistance.

On Nov. 18, Steven Kappes, PhD, co-chair of the USDA One Health Joint Working Group and deputy administrator of animal production and protection in the USDA Agricultural Research Service, published on the official USDA blog that ARS researchers were developing management techniques, supplements, and vaccines to reduce reliance on and use of antimicrobials.

“Finding alternatives to antibiotics has become a global issue as the demand for animal food products increases to meet the nutritional needs of a growing population,” he wrote.

A separate scientific report also published in November, in the journal Pediatrics, describes antimicrobial administration in agriculture as a threat to infants and children because of transmission through food of drug-resistant pathogens such as Salmonella, Campylobacter, and Staphylococcus aureus.

“The overuse and misuse of antimicrobial agents in veterinary and human medicine is, in large part, responsible for the emergence of antibiotic resistance,” the report states.

The report notes that most antimicrobial agents sold in the U.S. for administration to livestock animals, by volume, are considered important for human medicine.

“Most of the use involves the addition of low doses of antimicrobial agents to the feed of healthy animals over prolonged periods to promote growth and increase feed efficiency or at a range of doses to prevent disease,” the report states. “These nontherapeutic uses contribute to resistance and create new health dangers for humans.”

Related JAVMA content:

WHO warns of ‘post-antibiotic era’ (June 15, 2014)