Opportunities and challenges to improving antibiotic prescribing practices through a One Health approach: results of a comparative survey of doctors, dentists and veterinarians in Australia.
OBJECTIVES
To explore and compare the knowledge, attitudes and experiences of doctors, dentists and veterinarians (as prescribers) in relation to antibiotic use and antibiotic resistance (AbR), and to consider the implications of these for policy-making that support a One Health approach.


DESIGN
A cross-sectional survey conducted online.


SETTING
Doctors, dentists and veterinarians practising in primary, secondary or tertiary care in Australia.


PARTICIPANTS
547 doctors, 380 dentists and 403 veterinarians completed the survey.


MAIN OUTCOME MEASURES
Prescribers' knowledge, attitudes and perceptions of AbR, the extent to which a range of factors are perceived as barriers to appropriate prescribing practices, and perceived helpfulness of potential strategies to improve antibiotic prescribing in practice.


RESULTS
There was substantial agreement across prescriber groups that action on AbR is required by multiple sectors and stakeholders. However, prescribers externalised responsibility to some extent by seeing the roles of others as more important than their own in relation to AbR. There were common and context-specific barriers to optimal prescribing across the prescriber groups. Prescriber groups generally perceived restrictive policies as unhelpful to supporting appropriate prescribing in their practice.


CONCLUSIONS
The results have implications for implementing a One Health approach that involves doctors, dentists and veterinarians as key players to tackling the crisis of AbR. The findings are that (1) prescribers understand and are likely receptive to a One Health policy approach to AbR, (2) policy development should be sensitive to barriers that are specific to individual prescriber groups and (3) the development and introduction of interventions that might be perceived as reducing prescriber autonomy will need to be carefully designed and implemented.
['Zhuo|Annie|A|', 'Labbate|Maurizio|M|', 'Norris|Jacqueline M|JM|', 'Gilbert|Gwendolyn L|GL|', 'Ward|Michael P|MP|', 'Bajorek|Beata V|BV|', 'Degeling|Chris|C|', 'Rowbotham|Samantha J|SJ|', 'Dawson|Angus|A|', 'Nguyen|Ky-Anh|KA|', 'Hill-Cawthorne|Grant A|GA|', 'Sorrell|Tania C|TC|', 'Govendir|Merran|M|', 'Kesson|Alison M|AM|', 'Iredell|Jonathan R|JR|', 'Dominey-Howes|Dale|D|0000-0003-2677-2837']
D000328:Adult D000900:Anti-Bacterial Agents D001315:Australia D003430:Cross-Sectional Studies D003815:Dentists D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D000074823:One Health D010820:Physicians D010818:Practice Patterns, Physicians' D011795:Surveys and Questionnaires D018634:Veterinarians
antibiotic resistance health policy microbiology