Healthcare worker views on antimicrobial resistance in chronic respiratory disease

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.