Antibiotic Use by Adults with Wounds: Knowledge, Attitudes, Beliefs, and Behaviors

Objective: Because of an opening in the skin, patients may surmise wounds need antibiotics to heal. This can lead to an over and inappropriate use of antibiotics and the potential of antibiotic resistance. This study examined knowledge, attitudes, beliefs, and behaviors about antibiotic use by persons who had a wound within the past year.

Methodology: This was a descriptive, cross-sectional study that enrolled adults (N=505) across community-based (library, senior center, community recreation center, art center) and outpatient and hospital clinic sites; 26 of the participants reported a wound within the past year and are the focus. Participants were 57.7% women, African American (42.3%) or Caucasian (30.8%), and had some college education (65.4%). Participants responded to an antibiotic knowledge, attitudes, beliefs, and behavior questionnaire. Hierarchical agglomerative cluster analysis of variables was used to find clusters of items on the attitude, beliefs, and behavior questions. Descriptive statistics and Spearman’s rho correlation were also examined.

Results: The mean antibiotic knowledge score was 69%. Higher antibiotic knowledge was significantly related to higher education (rs=.71, p < .001) and higher rating of health (rs=.43, p=.028). There were 2 attitude and beliefs clusters: Most participants (>85%) recognized the need for medical supervision of antibiotic use (cluster 1); Belief about the need for antibiotics to prevent illness or treat wounds varied from 27% to 62% (cluster 2). There were 4 behavior clusters: Almost all filled and took the antibiotic if prescribed (96%, cluster 1); Disagreed with unapproved methods of obtaining antibiotics (>71%, cluster 2); and Used prescribed antibiotics correctly (>87%, cluster 3). Participants heard about antibiotic resistance through TV or radio (36%) or internet (40%), cluster 4.

Conclusion: Knowledge about antibiotics was low, while attitudes were positive to overly positive. These findings identify the need for non-commercial information on the role of antibiotics in wound care.