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. 2025 Jan 22;14(1):1.
doi: 10.1186/s13756-025-01515-8.

Healthcare worker views on antimicrobial resistance in chronic respiratory disease

Sachin Ananth  1 , Adekunle O Adeoti  2 , Animesh Ray  3 , Peter G Middleton  4 , Miquel Ekkelenkamp  5 , Stephanie Thee  6   7 , Anand Shah  8   9 ; AMR-Lung Clinical Research Collaboration
Collaborators, Affiliations

Healthcare worker views on antimicrobial resistance in chronic respiratory disease

Sachin Ananth et al. Antimicrob Resist Infect Control. .

Abstract

Background and objective: Antimicrobial resistance (AMR) is a global crisis, however, relatively little is known regarding its impact in chronic respiratory disease and the specific challenges faced by healthcare workers across the world in this field. We aimed to assess global healthcare worker views on the challenges they face regarding AMR in chronic respiratory disease.

Methods: An online survey was sent to healthcare workers globally working in chronic respiratory disease through a European Respiratory Society clinical research collaboration (AMR-Lung) focussed on AMR in chronic lung disease. Responses from different geographic regions were analysed.

Results: 279 responses were received across 60 countries. 54.5% of respondents encountered AMR in chronic respiratory disease weekly. There were differences in perceived high-priority diseases and species with AMR burden between Europe, Asia and Africa. 76.4% of respondents thought that inappropriate antimicrobial prescribing in chronic respiratory disease was common. However, only 43.4% of respondents thought that there were adequate antimicrobial stewardship programmes in their area for chronic respiratory disease, with limited availability in outpatient (29.0%) and ambulatory settings (24.7%). Developing rapid diagnostics for antimicrobial susceptibility (59.5%) was perceived to be the most common challenge in implementing antimicrobial stewardship, with an improved understanding of regional epidemiology of AMR strains the most important factor to improve outcome (55.2%).

Conclusions: AMR has significant perceived burden in chronic respiratory disease by healthcare professionals globally. However, current implementation of antimicrobial stewardship is limited, with significant challenges related to the availability of rapid diagnostics and understanding of regional epidemiology of AMR strains.

Keywords: Chronic bronchiectasis; Clinical epidemiology; Clinical respiratory disease; Infection and inflammation; Infection control; Respiratory infections; Tuberculosis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All survey respondents consented to the use of their responses for research purposes by completing the survey. All recorded data were anonymised. Consent for publication: Not applicable. Competing interests: Sachin Ananth and Adekunle O. Adeoti have none to declare. Animesh Ray reports research grants from Jolly Private Limited and fees for writing assignments from McGraw Hill. Peter G. Middleton reports trial involvement and speaker fees from Vertex, Insmed and Boehringer Ingelheim, not related to this current work. Miquel Ekkelenkamp reports research grants from the European Union, speaker fees from the University of Amsterdam and is a board member of the Dutch Antibiotic Policies Working Group. Stephanie Thee reports speaker fees from Vertex pharmaceuticals, Viatris and PARI GmbH. Anand Shah reports consultancy fees from Aztra-Zeneca and Pfizer, speaker fees from Insmed and research grants from Gilead Sciences, Pfizer and Vertex pharmaceuticals.

Figures

Fig. 1
Fig. 1
World map showing the survey respondents’ countries of origin (highlighted in red). Map created using MapChart.net [39]
Fig. 2
Fig. 2
The burden of antimicrobial resistance (AMR) in chronic respiratory disease. A Frequency that respondents encounter multi-drug resistant (MDR) organisms in respiratory infections. B Frequency that respondents’ treatment options are limited due to AMR in respiratory infections. C Frequency that respondents see patients with respiratory infections clinically deteriorate due to a lack of treatment options as a result of AMR. D The extent to which respondents feel that policymakers in their regions consider AMR in chronic lung disease to be an important topic
Fig. 3
Fig. 3
Geographical differences in the perceived burden of antimicrobial disease. A Disease areas with the greatest perceived burden of antimicrobial resistance. B Species with the greatest perceived priority in antimicrobial resistance. TB, tuberculosis; NTM, nontuberculous mycobacterium; COPD, chronic obstructive pulmonary disease. *P < 0.05; **P < 0.01; ***P < 0.001
Fig. 4
Fig. 4
Perceived application of regional antimicrobial stewardship in chronic lung disease. A Views on inappropriate antimicrobial prescribing regionally. B Views on the quality of regional antimicrobial stewardship programmes. C Setting of regional antimicrobial stewardship programmes for chronic respiratory disease. D Regional availability of infection prevention and control (IPC) programmes for multi-drug resistant variants of species in chronic lung disease
Fig. 5
Fig. 5
Future outlook of antimicrobial resistance (AMR) in chronic respiratory disease. A Views on the most important challenges in the implementation of antimicrobial stewardship in chronic respiratory disease. B Views on the most important research priorities in AMR in chronic respiratory disease. AI, artificial intelligence; TB, tuberculosis; COPD, chronic obstructive pulmonary disease; CF, cystic fibrosis. *P < 0.05; **P < 0.01; ***P < 0.001
See this image and copyright information in PMC

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