Public perceptions on antibiotic use and resistance: a social media-based multicountry survey during WAAW 2022

This study aimed to assess the global public's knowledge, attitudes, and practices concerning antibiotic use and antimicrobial resistance (AMR) during World Antimicrobial Awareness Week 2022 because public engagement is crucial in promoting responsible antibiotic use.

A validated trilingual questionnaire (Cronbach α 0.78) created in Google Forms was disseminated via the social media platforms of the Diagnostic and Antimicrobial Stewardship to Protect Antibiotics study group, yielding 766 responses from 30 countries. The survey explored the respondents' sociodemographic data, antibiotic knowledge, AMR awareness, and behavioral intentions in common clinical scenarios. Statistical analysis evaluated knowledge, attitudes, and practices scores by education level, academic background, and geographic region.

Respondents were predominantly from Asia and Africa. Higher education levels overall and a science background in particular were strongly associated with higher knowledge and more positive attitudes (P < 0.001). However, only 38% knew that antibiotics treat bacterial infections. Over half expected antibiotics for cold or flu symptoms; 31% would question why doctors were not prescribing them, and 18.5% would seek a second opinion. Awareness of the impact of antibiotics on the gut microbiome and fetal health was linked to reduced antibiotic-seeking behavior.

The findings primarily reflect engagement from the Middle East and the Indian subcontinent. The critical gaps in the public's understanding of appropriate antibiotic use support the need for school- and university-based AMR curricula, greater community engagement, and strategic use of digital platforms to foster responsible antibiotic practices.