Healthcare worker views on antimicrobial resistance in chronic respiratory disease
Authors: Ananth Sachin , Adeoti Adekunle O. , Ray Animesh , Middleton Peter G. , Ekkelenkamp Miquel , Thee Stephanie , Shah Anand ,   the AMR-Lung Clinical Research Collaboration, Fadeyi Abayomi , Ouedraogo Abdoul Risgou , Seminew Addishiwot Melesse , Roux Adele , Zafar Adnan , Tabyshova Aizhamal , Barac Aleksandra , Gileles-Hillel Alex , Kiefer Alexander , Hebestreit Alexandra , Tebboth Alice , Shoemark Amelia , Machado Ana , Santos-Silva André , Gramegna Andrea , Serediuk Andriy , Tramontano Angela , Salina Anna , Rolon Annie Navarro , Prakash Anoop , Gonçalves António , Singanayagam Aran , Mahadevaiah Arun H. , Muthusami Asha , Aujayeb Avinash , Aral Ayşe Önal , Kahl Barbara , Huggon Ben , Pereviznyk Bohdana , Vidal Braulio Chevalier , Bakki Bukar , Karadag Bulent , Ahmed Bushra , Doriane Calmés , Giang Cao Pham Ha , Sofia Carmelo , Cilloniz Catia , Paixão Cátia , Verwey Charl , Feldman Charles , Carter Charlotte , Premuda Chiara , Efobi Chizoba , Fraser Clementine , Alauzet Corentine , Vukoja Damir , Naqvi Danial , Cirillo Daniela Maria , Marghlani Dareen , Butler Daryl , Abelson David , Stickells David , Shrestha Deepa Kumari , Patel Deepa , Dhasmana Devesh J. , Dash Devi Jyoti , Ergle Diana , Topçu Dilara Ömer , Sykes Dominic L. , Esendagli Dorina Rama , Tatiana Dumitras , Papadopoulou Efthymia , Branco Elsa , Van Braeckel Eva , Liseki Evans Frexon , Robson Evie Alexandra , Victoria Fapohunda Temitope , de Fatima Magalhaes Gonzaga Maria , Bongomin Felix , Ringshausen Felix C. , Manyeruke Felix , Frost Freddy , de Weert Friso , Melania Garante Carmela , McDonald Garry , Héry-Arnaud Geneviève , De Leo Giancarlo , Amanda Gina , Piatti Gioia , Manfredini Giovanna , Antoine Grillon , Thouvenin Guillaume , Günther Gunar , Torres Hélida Conceição Cavalcante , Johansen Helle Krogh , Azmanov Henny , Elkhayat Hussein , Ahmed Hussein Mohamed , Clifton Ian , Martin-Loeches Ignacio , Ningtias Indiane Putri , Azevedo Ines , Muylle Inge , Shafiq Irfan , Gyselinck Iwein , Israëls Joel , Alqahtani Jaber S. , Ogunmodede James Ayodele , Jubrail Jamil , Nagar Jatin G. , Perotin Jeanne-Marie , Periselneris Jimstan , Congleton Jo , Arinze Johnmary T. , Fadare Joseph , Eze Joy , Simba Justus , Kumar Kartik , Hurt Katharine , Roy Kay , Verbeke Koen , Reveli Kristi , Poplawska Krystyna , Chun Kwok Wang , Ademola Lawani Olufemi , Prada Leidy , Gori Leonardo , Morlacchi Letizia Corinna , Rolobessy Linda Aprillia , Nwankwo Lisa , Carriera Lorenzo , Vladimirovna Loskova Elena , Finney Lydia , Elsheikh Mai S. , Hoxha Malvina , Restrepo Marcos I. , Arrais Margarete Lopes Teixeira , Gabrovska Maria , Cagnazzo Maria Grazia , Catarata Maria Joana , Bocchino Marialuisa , Di Stasio Mario , Lachowicz-Scroggins Marrah , Wambura Mary , Mpe Matlawene John , Pavitt Matthew , Nigro Mattia , Collins Melanie Sue , Uno Michelle , Gallego Miguel , Sathe Milind , Kalyoncu Mine , Abdullah Mohammad , Lichtblau Mona , Singh Mukesh , Kilima Mwanaada Ahmad , Lorent Natalie , Farahbakhsh Nazanin , Duong-Minh Ngoc , Hong Nguyen Pham Anh , Ronan Nicola , Travaglini Nicola , Bhattacherjee Nilotpal , Öztürk Nilüfer Aylin Acet , Kharima Nina Ratu Nur , Bandarage Niranjan Chandramal Lehupe , Kumar Nishith , Nias Nita Corry Agustine , Ikechukwu Nwosu Nnamdi , Mazulov Oleksandr , Bielousova Olga , Mashedi Olga , Elneima Omer , Bar-On Ophir , Güçlü Özge Aydın , Banerjee Pabitra , Yordanov Pavel , Ferreira Pedro Gonçalo , Goeminne Pieter , Jeena Prakash Mohan , Kenia Priti , Poda Priyanka , Patel Pujan H. , Yakubu Rafiuk Cosmos , Khalid Rameesha , Ganga Ranganath Thippanahalli , Ibraheem Rasheedat Mobolaji , Karunatillake Ravini , Ahmed Rawya , Figueiredo Ricardo , Hewitt Richard , Mohsin Ridzuan , Athanazio Rodrigo Abensur , Kumar Rohit , Amaro Rosanel , Raj SRaghul , Hippolyte Sabi , Louhaichi Sabrine , Tripodi Salvatore , Rovira-Amigo Sandra , Polat Sanem Eryılmaz , Manti Sara , Loof Sarah , Singh Saurabh , Pathmanathan Sega , Romeo Serena , Cuan-Escobar Shirley V. , Castillo-Corullón Silvia , Nataliya Sinchuk , Carr Siobhan B. , Dai Siyu , Lazova Snezhina , van Scheijen Sonja , Gohy Sophie , Mondal Soumitra , Wijesundara Srimali , Tryfon Stavros , Aliberti Stefano , Illing Stephan , Tinuke Suleiman Sherifat , Withanage Sumudu , Hämmerling Susanne , Qadeer Tariq , Qvist Tavs , Ahmad Tehreem , Fapohunda Temitope Victoria , Guillard Thomas , Othmer Till , Felton Tim , De Soyza Tony , Chaaban Toufic , Kahr Vanessa , Fernandes Vânia , Clérigo Vera , Saegeman Veroniek , Damaraju Vikram , Bataduwaarachchi Vipula Rasanga , Gundappa Vivek , Weygaerde Yannick Vande 
Published: January 2025

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.