UAC Seminar: “If patients had antibiotic treatment options, how would they choose? A trade-off between antibiotic resistance and cost”

If patients had antibiotic treatment options, how would they choose? A trade-off between antibiotic resistance and cost

We investigated people’s preferences about antibiotic treatments through an online survey. Of course, patients in real life do not “choose” the antibiotics. However, we asked 378 Swedish participants to imagine a scenario in which their doctor recommend the use of antibiotics to avoid potential complications. So, not a life threatening situation but one where antibiotics should be used. We described the antibiotic treatment options through varying levels of five characteristics: cost, side effects, failure rate, treatment duration, and contribution to antibiotic resistance. The first four are typical medicines characteristics. The potential contribution of individual use of antibiotics to antibiotic resistance was added to see whether people would care about it and, if so, to what extent. Respondents had to choose multiple times between two treatment options in which there were different levels of these five characteristics.

Overall, for the majority of participants, contribution to antibiotic resistance was the most important characteristic and they tried to minimise their impact even if this entailed a personal effort. Almost as important as contribution to antibiotic resistance was the cost of the treatment.

We found differences in participants’ preferences and identified three main patterns, mainly influenced by age, financial vulnerability and health literacy.

Our results suggest that the behaviour of lay people may be influenced by concerns over the rise of antibiotic resistance. Therefore, stressing individual responsibility for antibiotic resistance in clinical and societal communication has the potential to affect personal decision making.