title: Patient and public understanding and knowledge of antimicrobial resistance and stewardship in a UK hospital: should public campaigns change focus?
abstract: The rising global tide of antimicrobial resistance is a well-described phenomenon. Employing effective and innovative antimicrobial stewardship strategies is an essential approach to combat this public health threat. Education of the public and patients is paramount to enable the success of such strategies.
  
  
  
  A panel of hospital multidisciplinary healthcare professionals was set up and a short quiz containing true/false statements around antimicrobial stewardship and resistance was designed and piloted. An educational leaflet with the correct replies and supporting information was also produced and disseminated. Participants were recruited on a single day (18 November 2015) from the hospital outpatient clinics and the hospital outpatient pharmacy waiting room.
  
  
  
  One hundred and forty-five completed quizzes were returned, providing a total of 1450 answers. Overall, 934 of 1450 (64%) statements were scored correctly whilst 481 (33%) were scored incorrectly; 35 (3%) statements were left unscored. We speculate that these results may demonstrate that respondents understood the statements, as only a small proportion of statements were left unanswered. The question dealing with the definition of antimicrobial resistance and the question dealing with the definition of antimicrobial stewardship obtained the most incorrect replies (85% and 72%, respectively). However, a specific factual recall question regarding only one microorganism (MRSA) received the most correct responses (99%).
  
  
  
  We describe a simple, innovative method of engagement with patients and the general public to help educate and disseminate important public health messages around antimicrobial resistance and stewardship. We also identified the need for public health campaigns to address the knowledge gaps found around this topic.
authors.affiliation: Pharmacy Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.|NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London W12 0NN, UK.
authors.forename: Christianne
authors.initials: C
authors.lastname: Micallef
authors.affiliation: Pharmacy Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
authors.forename: Kornelija
authors.initials: K
authors.lastname: Kildonaviciute
authors.affiliation: NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London W12 0NN, UK.
authors.forename: Enrique
authors.initials: E
authors.lastname: Castro-Sánchez
authors.affiliation: Pharmacy Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Scibor-Stepien
authors.affiliation: Pharmacy Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
authors.forename: Reem
authors.initials: R
authors.lastname: Santos
authors.affiliation: National Infection Service, Public Health England, Microbiology Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: Sani H
authors.initials: SH
authors.lastname: Aliyu
authors.affiliation: National Infection Service, Public Health England, Microbiology Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Cooke
authors.affiliation: Pharmacy Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pacey
authors.affiliation: NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London W12 0NN, UK.
authors.forename: Alison H
authors.initials: AH
authors.lastname: Holmes
authors.affiliation: National Infection Service, Public Health England, Microbiology Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK david.enoch@addenbrookes.nhs.uk.
authors.forename: David A
authors.initials: DA
authors.lastname: Enoch
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000188:drug therapy*; D004363:Drug Utilization / Q000592:standards*; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D006113:United Kingdom
chemical_list: D000890:Anti-Infective Agents