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Comparing antimicrobial resistance to COVID-19 does not reduce antibiotic seeking intentions in US adultsComparing Antibiotic Resistance to COVID-19 May Not Change Patient Behavior

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Key Takeaway
Note that comparing antimicrobial resistance to COVID-19 does not significantly change patient intent to seek antibiotics.

This randomized online survey enrolled 972 US adults to evaluate the impact of different messaging formats on intentions regarding antimicrobial resistance (AMR). Participants were exposed to one of three types: a written message describing the AMR crisis, a written message comparing AMR to COVID-19, or a series of poster-like graphics comparing AMR to COVID-19.

The primary outcome was the intention to seek unnecessary antibiotics. Results showed no statistically significant differences between the three messaging types regarding the desire to take antibiotics (P =.157). Additionally, there were no statistically significant differences in the intention to visit a primary care clinician (P =.625) across the different communication formats.

Several factors were associated with antibiotic-seeking intentions. Older age and independent or third-party political affiliation were associated with lower intentions. Conversely, medical maximizing, prior antibiotic use, being vaccinated for COVID-19, and pride in that status were associated with higher intentions. No adverse events were reported.

A key limitation is that the study measured self-reported intentions rather than actual clinical behaviors. Furthermore, comparing the threat of AMR to the COVID-19 pandemic did not reduce antibiotic-seeking intentions. These results suggest that utilizing COVID-19 as a comparative frame may not be an effective strategy for public health messaging regarding antimicrobial stewardship.

Researchers conducted an online survey with 972 adults in the United States. The study looked at three different ways to talk about antimicrobial resistance (AMR). These methods included a written description of the crisis, a written comparison between AMR and COVID-19, and a series of graphics comparing the two issues.

The results showed that none of these communication styles significantly changed how many people intended to seek out antibiotics or visit a primary care doctor. Specifically, the study found no significant difference in the desire to take antibiotics across the three groups. This suggests that using COVID-19 as a comparison point might not be an effective way to change public behavior regarding antibiotic use.

Several personal factors did influence intentions. People who were older or had specific political affiliations were less likely to seek unnecessary antibiotics. Other factors, such as previous antibiotic use and being vaccinated for COVID-19, were linked to higher intentions to seek them. Because this study measured what people intended to do rather than their actual actions in a clinic, the results should be viewed as an early look at communication strategies.

What this means for you:
Comparing antimicrobial resistance to COVID-19 did not change how often people planned to seek unnecessary antibiotics.

Common questions

Does comparing antibiotic resistance to COVID-19 change how people act?

The study found no statistically significant differences between the three types of messages. Whether patients received a written description, a written comparison, or graphics comparing antimicrobial resistance to COVID-19, their intentions to seek unnecessary antibiotics remained the same.

What factors influenced people's desire for antibiotics?

Several personal factors were linked to higher intentions to seek antibiotics. These included a history of prior antibiotic use, medical maximizing, and being vaccinated for COVID-19. Conversely, older age and specific political affiliations were associated with lower intentions.

How many people were involved in this study?

The study was an online survey involving 972 adults in the United States. It specifically looked at how different communication styles regarding antimicrobial resistance impacted their plans to visit a doctor or seek antibiotics.

Study Details

Study typeRct
Sample sizen = 972
EvidenceLevel 2
Follow-up504.0 mo
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Antimicrobial resistance (AMR) is an urgent health threat. Effective communication about AMR and avoiding antibiotics for viral infections is a public health priority. Here, we evaluated whether comparing the AMR crisis to the coronavirus disease 2019 (COVID-19) pandemic could enhance public understanding of AMR and reduce intentions to seek unnecessary antibiotics. METHODS: In this randomized online survey (March-April 2024), US adults were randomized to receive 1 of 3 messages: (1) written message describing the AMR crisis (control); (2) written message comparing AMR to the COVID-19 pandemic; or (3) a series of poster-like graphics comparing AMR to the COVID-19 pandemic. Respondents then read a scenario describing a viral respiratory infection (where antibiotics are not clinically indicated) and asked to indicate whether they would (1) respond by visiting a primary care clinician and (2) desire to take antibiotics. RESULTS: The final sample (N = 972, completion = 90%) had a mean age of 42 years and 58% identified as female. No statistically significant differences were found between messages for intention to visit a primary care clinician (P = .625) or desire to take antibiotics (P = .157). Across all respondents, older age and independent/third-party political affiliation were associated with lower antibiotic-seeking intentions, whereas medical maximizing, prior antibiotic use, being vaccinated for COVID-19, and pride in that status were associated with higher intentions. CONCLUSIONS: Comparing the threat of AMR to the COVID-19 pandemic did not reduce antibiotic-seeking intentions, indicating this analogy may not be an effective messaging strategy. Adults with greater care-seeking behaviors and preferences were more likely to report antibiotic-seeking intentions.
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