Exploring Healthcare Workers' Knowledge, Attitudes and Behaviors to Antibiotic Use, Including in Acne, and Antibiotic Resistance in English Correctional Facilities in 2024.

Background: Antimicrobial resistance (AMR) is a global health threat, driven in part by inappropriate antibiotic use. Vulnerable populations, such as individuals within the criminal justice system, potentially face heightened AMR risks due to infection control challenges and health inequalities. This study explored health and justice healthcare professionals' views of AMR and antibiotic prescribing to identify challenges and opportunities for action. Methods: A quantitative survey among healthcare professionals in English correctional facilities assessed knowledge, attitudes, and behaviors towards AMR and prescribing, including acne prescribing. The survey was structured using COM-B and included 82 Likert-scale statements and 7 key AMR knowledge questions. Results: There were 24 respondents; 54.2% were pharmacy professionals. Both pharmacy and non-pharmacy professionals demonstrated strong AMR understanding, with 5/7 knowledge questions answered correctly by everyone. Motivation-related responses were generally positive, with the median response corresponding to strong agreement for five of six questions. Although opportunity and capability responses were generally positive, they indicated several areas where respondents reported lower levels of confidence and knowledge, such as having the opportunity to run searches on the clinical system to monitor antibiotic prescribing. Overall, 79% of respondents were able to answer all seven key AMR knowledge questions correctly. Conclusions: This study provides preliminary insights into prescribing behavior in health and justice settings, emphasizing the need for further research to understand health and justice healthcare workers and develop appropriate interventions to reduce AMR.