Towards a better understanding of patients' perspectives of antibiotic resistance and MRSA: a qualitative study.

BACKGROUND Patients' expectations for antibiotics are known to influence prescribing, but little is known about patients' understanding of, and attitudes to, antibiotic resistance and whether these could modify treatment expectations. OBJECTIVE To explore primary care patients' perspectives on antibiotic resistance and methicillin-resistant Staphylococcus aureus (MRSA) and understand how these could modify expectations for antibiotics. METHODS A qualitative investigation using focus groups and semi-structured interviews with patients purposely sampled from low, intermediate and high antibiotic consumption groups from socio-economically contrasting general practices. RESULTS There was uncertainty concerning the nature and implications of antibiotic resistance for both individuals and the wider community. While some patients viewed antibiotic resistance as a problem for society, most did not see it as something that would affect them personally. Many thought that science would provide the solution through the development of new drugs. Responsibility for antibiotic resistance was mostly attributed to 'other' patients and GPs who had respectively overused and overprescribed antibiotics in the past. As MRSA was mainly seen as a hospital-based problem, blame was largely directed at hospital management and, to a lesser degree, doctors, nurses and cleaners. Concerns about antibiotic resistance were not regarded as a reason to modify individual use of antibiotics. CONCLUSIONS Many primary care patients are unaware of what antibiotic resistance is and how it arises. The causes of, and responsibility for, antibiotic resistance are usually attributed to external rather than personal factors and patients perceive that its solutions are outside of their control.