29 May 2025
Researchers at Royal Brompton and Harefield hospitals have published the results of a global patient survey on antimicrobial resistance (AMR) in chronic lung disease, highlighting the likely significant burden of AMR and a need for better accessibility to quality healthcare.
Led by Dr Anand Shah, respiratory consultant, the study involved a global survey of patients with chronic respiratory disease, with the aim to comprehensively assess patients’ experiences, knowledge, priorities and concerns regarding AMR.
Chronic respiratory disease and antimicrobial resistance
Chronic respiratory disease is an umbrella term used to describe several conditions, including asthma, bronchiectasis and cystic fibrosis. These patients are generally more prone to developing respiratory infections due to several factors, including weakened lung defences, thick mucus, airway obstruction and frequent exacerbations which damage the lungs.
When these patients develop an infection, they are usually prescribed antimicrobial drugs, such as antibiotics or antifungal medication. These work on the disease-causing microorganisms, such as bacteria, viruses, fungi, or parasites, by either killing them or stopping their growth.
However, frequent use of these drugs has led to a global increase in AMR, where the microorganisms evolve to resist or counter the effects of these once-effective drugs.
The patient perspective
The researchers recently published global perspectives of healthcare workers on AMR in chronic lung disease and in parallel have now studied the perspective of patients.
Despite the global threat of AMR, this is the first time researchers have attempted to determine the perspective of people with chronic respiratory disease and their priorities, to this scale.
The results of the survey highlighted some interesting findings, including:
- Almost a third of patients surveyed reported an infection associated with AMR.
- Over 75% of patients feel that AMR is a personal and global threat.
- A significant number of patients (17%) admitted to occasionally taking antimicrobial drugs without a prescription.
- Around 40% of individuals said they had no lung sample sent for testing before their last course of antimicrobial therapy.
- Patients living in higher income countries are more likely to be aware of antimicrobial resistance and are less likely to use antimicrobials without a prescription, compared to lower to middle income countries.
- 26% of individuals had never heard of AMR before the survey, with almost all individuals strongly agreeing on the importance of better education and awareness of AMR in chronic lung disease.
Dr Shah expanded on the findings:
“Despite the global threat of AMR, as well as increasing evidence of the burden in individuals with chronic lung disease, we actually know relatively little at present about how AMR impacts chronic lung disease with few studies having been performed to date.
“This is the first largescale study to capture global patient perspectives of AMR in chronic lung disease and worryingly highlights a likely significant burden, geographic variability, high rates of empirical antibiotic usage and a need for greater education and awareness.”
Dr Shah went on to explain what he hopes will come from these results.
He said: “This work is part of a larger research programme through the AMR-Lung clinical research collaboration trying to tackle antimicrobial resistance in chronic lung disease and is critically important to understand the next steps.
“Firstly, we have just launched an international prospective registry to capture the prevalence of AMR in chronic lung disease accurately. When we consider any intervention such as stewardship to reduce antimicrobial resistance in chronic lung disease, it will be imperative to understand patient views around antimicrobial usage and results from this study will be used to develop these research strategies.”
The study was performed through the AMR-Lung, a European Respiratory Society clinical research collaboration, and in collaboration with the European Lung Foundation. The international survey was undertaken across six continents in 57 countries, with over 2,000 patients taking part.
You can read the full paper here.
You can also find out more about antimicrobial resistance with this recording of Dr Shah speaking at a Coffee Talk event hosted by the European Respiratory Society.
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