What the public in England know about antibiotic use and resistance in 2020: a face-to-face questionnaire survey

Cliodna McNulty, Brieze Read, Anna Quigley, Neville Q. Verlander, Donna M. Lecky

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OBJECTIVES: To describe public attitudes and knowledge around antibiotic activity, resistance and use. 

DESIGN: Face-to-face household 18 question survey using computer-assisted data collection undertaken by Ipsos Market and Opinion Research International. 

SETTING: Randomly selected households across England, January-February 2020. 

PARTICIPANTS: 2022 adults (aged 15+,) including 521 black, Asian and minority ethnic (BAME) participants, and 406 aged 15-25 years olds. 

MAIN OUTCOME MEASURES: Responses to questions about antibiotic activity, resistance and expectations for antibiotics and trust in healthcare professionals. Analyses were weighted to obtain estimates representative of the population with multivariable analysis undertaken for questions with five or more significant univariate variables. 

RESULTS: 84% stated they would be pleased if their general practitioner (GP) said they did not need antibiotics. Trust in GPs to make antibiotic decisions remains high (89%) and has increased for nurses (76%) and pharmacists (71%). Only 21% would challenge an antibiotic decision; this was significantly greater in BAME participants (OR 2.5; 95% CI 1.89 to 3.35). 70% reported receiving advice when prescribed antibiotics. Belief in benefits of antibiotics for ear infections was very high (68%). Similar to 2017, 81% agreed that antibiotics work for bacterial, 28% cold and influenza viruses. 84% agreed antibiotic resistant bacteria (ARB) are increasing, only 50% agreed healthy people can carry ARB and 39% agreed there was nothing they personally could do about ARB. Social grade DE and BAME participants, and those with less education had significantly less understanding about antibiotics and resistance. 

CONCLUSIONS: As trust in healthcare practitioners is high, we need to continue antibiotic education and other interventions at GP surgeries and community pharmacies but highlight that most ear infections are not benefitted by antibiotics. Targeted interventions are needed for socioeconomic DE, BAME groups and previous antibiotic users. We need to explore if increasing perceived personal responsibility for preventing ARB reduces antibiotic use.

Original languageEnglish
Article numbere055464
JournalBMJ Open
Issue number4
Publication statusPublished - 6 Apr 2022

Bibliographical note

Funding Information: This study was funded by Public Health England.

Open Access: Re-use permitted under CC BY-NC. No commercial re-use.

Publisher Copyright: © Author(s) (or their employer(s)) 2022. Published by BMJ.

Citation: McNulty C, Read B, Quigley A, et al. What the public in England know about antibiotic use and resistance in 2020: a face-to-face questionnaire survey. BMJ Open 2022;12:e055464.



  • infection control
  • public health
  • public health


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