“Contradictio in opinionibus”: The Swiss public’s attitudes and beliefs about antibiotics and antibiotic resistance

Abstract

One of the actors involved in the growing risk of antibiotic resistance is the general public. Its perceptions and decisions (i.e., its mental models) regarding antibiotics and antibiotic resistance determine how much antibiotics are used and how willing people are to adopt measures to prevent the spread of resistant bacteria. For the development of intervention strategies and materials that promote the prudent use of antibiotics and the adoption of preventive measures, we thus need to understand the public’s mental models of antibiotics and antibiotic resistance. We conducted an interview study (N = 10) and an online survey (N = 1,260) to investigate the Swiss public’s attitudes, beliefs, knowledge and perceived social influences regarding antibiotics and antibiotic resistance. Moreover, using the survey data, we examined how these concepts—in addition to people’s demographic characteristics, experiences with antibiotics and cultural values—relate to their request for antibiotics and their willingness to adopt preventive measures against antibiotic resistance. In both studies, respondents held contradicting opinions (i.e., beliefs and attitudes) about antibiotics and antibiotic resistance. The same individuals, for example, correctly knew that bacteria became resistant against antibiotics and, at the same time, incorrectly believed that their own body became resistant. The survey data additionally showed that respondents’ contradicting attitudes and beliefs affected their request for antibiotics. Respondents’ request for antibiotics was mostly predicted by egoistic values, knowledge about antibiotics and the perceived benefits of antibiotics. Alternatively, their willingness to adopt preventive measures was mainly related to traditional values and biospheric values, their knowledge about preventive measures as well as their perceived risks of antibiotics and of antibiotic resistance. Stronger perceived norms in respondents’ social environment regarding prudent antibiotic usage were related to both a lower request for antibiotics and a higher willingness to adopt preventive measures. In sum, different psychological factors need to be addressed in an intervention to promote both a more prudent antibiotic usage and the adoption of preventive measures among the general public. We will particularly discuss how opposing attitudes and beliefs can be addressed in such intervention materials.