General Perceptions and Knowledge of Antibiotic Resistance and Antibiotic Use Behavior: A Cross-Sectional Survey of US Adults
4. Materials and Methods
4.1. Study Design and Participants
4.2. Survey Design
4.3. Data Analysis
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
- Have you ever taken an antibiotic? [Yes/No/Not Sure]
- Do antibiotics kill viruses? [Yes/No/Not Sure]
- Have you ever shared an antibiotic (either received it or provided it to another family member, friend, co-worker, etc.)? [Yes/No]
- Have you or anyone you know every obtained antibiotics without a prescription? [Yes/No/]
- Have you ever directly asked your doctor for an antibiotic (for either yourself or a child)? [Yes/No]
- Has your doctor ever spoken with you about side effects of antibiotics? [Yes/No/Not Sure]
- Has your doctor talked about antibiotic resistance with you? [Yes/No/Not Sure]
- In a single sentence, how would you define antibiotic resistance? [free text response]
- Have you or anyone you know ever had an infection with an antibiotic-resistant bacteria (e.g., MRSA, superbug, etc.)? [Yes/No/Not Sure]
- If you answered Yes above: Would you be willing to be contacted to talk more about your experience with an antibiotic-resistant infection?
- How concerned are you personally about antibiotic resistance? [Likert Scale: 1 = not at all concerned, 10 = extremely concerned]
- What is your age? [Multiple choice: 21–29, 30–39, 40–49, 50–59, 60–69, 70+]
- What is your gender?
- Prefer not to answer
- What is your race?
- Black or African-American
- Native Hawaiian or Pacific Islander
- American Indian/Alaskan Native
- refer not to answer
- What is your ethnicity?
- Hispanic or Latino
- Non-Hispanic or Latino
- Prefer not to answer
- What state do you live in?
- [drop down menu of all 50 states]
- Do you consider your home to be in an area that is:
- Prefer not to answer
- What is the highest degree or level of school you have completed? If currently enrolled, mark the previous grade or highest degree received.
- Some high school
- High school graduate or equivalent
- Some college credit
- Associate degree
- Bachelor’s degree (BA, BS)
- Master’s degree (MA, MBA, MPH, MS, MSW)
- Doctorate degree, non-healthcare (for example: EdD, JD, PhD)
- Healthcare Professional degree (for example: MD, PharmD, DDS, BSN, RN)
- Prefer not to answer
- Do you have children?
- Currently expecting
- Prefer not to answer
- Are you partially or fully involved in healthcare decisions for a parent or other older adult? [Yes/No}
- If you would like to receive periodic updates on antibiotic resistance research/news and public health messages?
- Would prefer not to receive these messages
- In regard to antibiotic resistance, what do you think is the most important area to focus research efforts on? [free text]
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|Highest Level of Education|
|≤High School Graduate||19||3%|
|Some College/Associate’s Degree||124||19%|
|Has Children b||383||59%|
|Healthcare decision maker for older adult||212||32%|
|p Value +||Age < 40|
|Age ≥ 40|
|p Value ^|
|Has shared an antibiotic (either received it or provided it).||119/655 (18%)||40/143 (28%)||79/510 (15%)||p < 0.01||36/183 (20%)||83/471 (18%)||p = 0.54|
|Has obtained or knows someone who has obtained antibiotics without a prescription?||154/656 (23%)||39/143 (27%)||115/511 (22.5)||p = 0.23||60/183 (33%)||94/472 (20%)||p < 0.01|
|Has asked a doctor for an antibiotic (self or for child)?||309/656 (47%)||78/143 (55%)||231/511 (45%)||p = 0.05||79/183 (43%)||230/472 (49%)||p = 0.20|
|Antibiotic Resistance Themes a|
|Ineffective antibiotics||61/635 (10%)||12/129 (9%)||49/504 (10%)||p < 0.01||11/177 (6%)||50/458 (11%)||p < 0.01|
|Bacteria adapts/mutates||223/635 (35%)||33/129 (26%)||189/504 (37%)||82/177 (46%)||141/458 (31%)|
|Misuse or overuse of antibiotics||142/635 (22%)||24/129 (19%)||117/504 (23%)||33/177 (19%)||109/458 (24%)|
|Person/body immunity to|
|46/635 (7%)||13/129 (10%)||33/504 (7%)||5/177 (3%)||41/458 (9%)|
|Resistant bacteria no elaboration,|
|141/635 (22%)||36/129 (28%)||105/504 (21%)||38/177 (21%)||103/458 (22%)|
|Incorrect w/no consistent theme||22/635 (3%)||11/129 (8%)||11/504 (2%)||8/177 (5%)||14/458 (3%)|
|Antibiotic Resistance Themes a||Shared (Received/Provided) n (%) b||Obtained (Self or Other) n (%) c||Asked Doctor for Antibiotics n (%) d|
|Yes (n = 113)||No (n = 520)||Yes (n = 151)||No (n = 483)||Yes (n = 301)||No (n = 333)|
|Misuse or overuse of antibiotics||19||(17%)||122||(23%)||32||(21%)||110||(23%)||76||(25%)||65||(19%)|
|Resistant bacteria no elaboration||23||(20%)||118||(23%)||31||(21%)||110||(23%)||61||(20%)||80||(24%)|
|Person/Body immunity to antibiotics||12||(10.5%)||34||(7%)||6||(4%)||40||(8%)||32||(11%)||14||(4%)|
|Incorrect w/no consistent theme||3||(2.5)||19||(4%)||4||(3%)||18||(4%)||10||(3%)||12||(4%)|
|Doctor Discussed Antibiotic Resistance|
(n = 290)
(n = 367)
|Shared an antibiotic (either received it or provided it)||56 (19)||63 (17)||p = 0.48|
|Obtained or knows someone who has obtained antibiotics without a prescription||66 (23)||88 (24)||p = 0.70|
|Asked a doctor for an antibiotic (self or for child)||167 (58)||142 (39)||p < 0.01|
|Antibiotic Resistance Themes||p = 0.95|
|Ineffective antibiotics||27 (10)||34 (10)|
|Bacteria adapts/mutates||94 (33)||129 (37)|
|Miss or over use of antibiotics||66 (23)||76 (21)|
|Person/body immunity to antibiotics||22 (8)||24 (7)|
|Resistant bacteria no elaboration, neutral||65 (23)||76 (21)|
|Incorrect, no consistent theme||9 (3)||13 (4)|
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McCracken, C.M.; Tucker, K.J.; Tallman, G.B.; Holmer, H.K.; Noble, B.N.; McGregor, J.C. General Perceptions and Knowledge of Antibiotic Resistance and Antibiotic Use Behavior: A Cross-Sectional Survey of US Adults. Antibiotics 2023, 12, 672. https://doi.org/10.3390/antibiotics12040672
McCracken CM, Tucker KJ, Tallman GB, Holmer HK, Noble BN, McGregor JC. General Perceptions and Knowledge of Antibiotic Resistance and Antibiotic Use Behavior: A Cross-Sectional Survey of US Adults. Antibiotics. 2023; 12(4):672. https://doi.org/10.3390/antibiotics12040672Chicago/Turabian Style
McCracken, Caitlin M., Kendall J. Tucker, Gregory B. Tallman, Haley K. Holmer, Brie N. Noble, and Jessina C. McGregor. 2023. "General Perceptions and Knowledge of Antibiotic Resistance and Antibiotic Use Behavior: A Cross-Sectional Survey of US Adults" Antibiotics 12, no. 4: 672. https://doi.org/10.3390/antibiotics12040672