Most Swiss healthcare workers worry about antibiotic resistance but few see their own role in fighting it

Healthcare workers in eastern Switzerland are far more worried about antibiotic resistance as a national problem than about it happening in their own hospitals and clinics, according to a large cross-sectional survey published in the journal Antimicrobial Resistance & Infection Control. The study, based on a 141-item questionnaire sent to members of the SURPRISE+ cohort in November 2022, found a striking gap between how staff judge the country’s antibiotic use and how they judge their own institutions and their own prescribing.

Of the 3,514 healthcare workers invited, 1,505 completed the survey, a response rate of 43 percent. Participants came from 14 institutions in eastern Switzerland and were grouped into four professional categories: physicians, nurses, paramedics and other professionals. Ten percent of respondents were physicians, 45 percent nurses, 15 percent paramedics and 29 percent other professionals. The median age was 45 years, with a range from 16 to 69, and 81 percent of participants were women.

The survey covered knowledge and attitudes about antimicrobial resistance, antibiotic prescribing habits and personal antibiotic use. The results show broad awareness of the problem at the national level. Nearly three quarters of participants, 73.8 percent or 1,111 of 1,505, said they were concerned about antimicrobial resistance in Switzerland. Similarly, 64.4 percent, or 969 respondents, believed that too many antibiotics are prescribed in the country overall.

Yet that concern dropped sharply when the question turned to respondents’ own workplaces. Only 37.9 percent, or 570 of 1,505, expressed concern about antimicrobial resistance in their own healthcare institution, and just 24.6 percent, or 371, thought that too many antibiotics were prescribed there.

Physicians showed the same self-versus-others discrepancy. Among the 123 physicians who answered, only 13 percent, or 16, believed that they themselves prescribe antibiotics too often, while 43.1 percent, or 53, felt that their colleagues overprescribe. In other words, doctors were more than three times as likely to attribute overprescribing to peers than to themselves.

Perhaps the most concerning finding concerns perceived responsibility. Only 43.2 percent of physicians, 67 of 155, and a mere 9.4 percent of nurses, 64 of 682, believed that they personally play a key role in controlling antimicrobial resistance. The study’s authors describe this limited sense of agency among healthcare workers as worrying, because frontline staff are central both to prescribing antibiotics and to preventing the spread of resistant pathogens in healthcare settings.

The appetite for more education was substantial. A total of 56.1 percent of participants, 845 of 1,505, expressed a desire for more information or training on antimicrobial resistance and antibiotic use, with this wish expressed particularly by physicians and nurses. The authors argue that their findings highlight the need for targeted educational interventions to raise awareness and strengthen engagement in antimicrobial stewardship programmes.

The survey also examined the respondents’ own antibiotic use. Some 18.2 percent, or 274 of 1,505, reported taking at least one antibiotic in the previous 12 months. The vast majority, 93.9 percent or 1,413 participants, said they had taken antibiotics strictly as prescribed.

As a cross-sectional survey, the study captures a snapshot of attitudes at a single point in time and cannot establish causal relationships or trends over time. Its findings are limited to healthcare workers from 14 institutions in eastern Switzerland who chose to respond, so results may not generalise to all Swiss healthcare staff or to other countries. Self-reported behaviour, including personal antibiotic use, may also be subject to reporting bias.

Nevertheless, the central message is clear and quantified: Swiss healthcare workers in this cohort demonstrated a marked discrepancy between their self-assessment and their perceptions of others regarding antibiotic resistance and antibiotic overuse. The authors conclude that these findings highlight the need for targeted educational interventions to enhance awareness and engagement in antimicrobial stewardship.

Subject of Research: Knowledge, attitudes and behaviour of Swiss healthcare workers regarding antibiotic use and antimicrobial resistance

Article Title: Knowledge, attitudes and behaviour of Swiss healthcare workers on antibiotic use and resistance: a cross-sectional study

Article References: Wichmann, M., Grässli, F., Dörr, T., Kahlert, C. R., Vuichard-Gysin, D., Badinski, T., Stocker, R., Ruetti, M., Schlegel, J. M., Kuster, S. P., Kohler, P., Cusini, A., for the SURPRISE (SURveillance of infectious diseases among health Professionals In SwitzErland) Study Group, Cusini, A., Grässli, F., Kahlert, C. R., Keller, J., Kessler, S., Kohler, P., … Vuichard-Gysin, D. (2026). Knowledge, attitudes and behaviour of Swiss healthcare workers on antibiotic use and resistance: a cross-sectional study. Antimicrobial Resistance & Infection Control. https://doi.org/10.1186/s13756-026-01845-1

Image Credits: AI Generated

DOI: 10.1186/s13756-026-01845-1

Keywords: antimicrobial resistance, antibiotic prescribing, healthcare workers, Switzerland, cross-sectional survey, antimicrobial stewardship, physicians, nurses, self-prescription, infection control, Knowledge, attitudes