Knowledge and Attitudes towards Antibiotic Use and Resistance - A Latent Class Analysis of a Swedish Population-Based Sample

BackgroundIn 2006, a study investigating knowledge and attitudes regarding antibiotic use and resistance in Sweden, indicated high level of knowledge but also areas in need of improvement.Objective(i) To provide an update on the knowledge and attitudes to antibiotic use and resistance of the Swedish population, and (ii) to identify which groups within the population are in particular need of improved knowledge or attitudes.MethodsA questionnaire was sent by post in 2013 to 2,500 randomly-selected individuals aged 18–74, living in Sweden. Latent class analyses were conducted to group respondents based on their responses. The association between socio-demographic characteristics and the probability of belonging to each latent class was assessed.ResultsThe response rate was 57%. Ninety-four per cent of the responders knew that bacteria could become resistant to antibiotics and the majority answered correctly to the questions regarding antibiotic resistance development. The respondents expressed confidence in doctors who decided not to prescribe antibiotics. Three latent classes related to ‘knowledge regarding antibiotic use and resistance’, two regarding ‘attitudes towards antibiotic accessibility and infection prevention’ and three regarding ‘attitudes towards antibiotic use and effects’ were revealed. Men, younger and more educated people were more knowledgeable but males had a less restrictive attitude. Respondents with high levels of knowledge on antibiotics were more likely to have appropriate restrictive attitudes to antibiotics.ConclusionKnowledge on antibiotic use and resistance is maintained high and has improved in Sweden compared to 2006. People with lower education and elderly are especially in need of improved knowledge about antibiotic use and resistance.

背景：2006年，一项针对瑞典民众抗生素使用与耐药性相关认知及态度的调研显示，瑞典民众对抗生素相关知识的掌握程度较高，但仍存在诸多有待改进之处。目的：（1）更新瑞典民众对抗生素使用与耐药性的认知及态度现状；（2）明确瑞典民众中哪些群体亟需提升相关认知或优化态度。方法：本研究于2013年通过邮寄问卷的方式，向瑞典境内2500名随机抽取的18至74岁居民发放问卷。基于受访者的作答数据开展潜类别分析（Latent Class Analysis），对受访者进行分组；同时评估社会人口统计学特征与归入各潜类别的概率之间的关联。结果：本次调研的应答率为57%。94%的受访者知晓细菌可产生抗生素耐药性，多数受访者能正确回答关于抗生素耐药性发展的相关问题。受访者对决定不开具抗生素处方的医生表示信任。研究共识别出3类与“抗生素使用与耐药性认知”相关的潜类别、2类与“抗生素可及性及感染防控态度”相关的潜类别，以及3类与“抗生素使用与效应态度”相关的潜类别。男性、较年轻及受教育程度更高的人群对抗生素相关知识的掌握程度更高，但男性的态度限制性更低。对抗生素相关知识掌握程度较高的受访者，更倾向于持有恰当的限制性用药态度。结论：与2006年相比，瑞典民众对抗生素使用与耐药性的认知仍维持在较高水平且有所提升。受教育程度较低的人群及老年群体，尤其亟需提升抗生素使用与耐药性相关知识储备。