review · Clinical Microbiology and Infection
A systematic review and meta-analysis of 227 studies across 98 countries evaluated public knowledge regarding antibiotic use and resistance. The findings show that 73.2 percent of the public understand that antibiotics are effective against bacterial infections, and 72.5 percent recognise that unnecessary use reduces their effectiveness. In contrast, significant knowledge gaps persist. Only 42.1 percent of individuals recognise that antibiotics are ineffective against viral infections, with national rates spanning from 7.2 percent in Lao People's Democratic Republic to 77.0 percent in Sweden. Additionally, only 39.1 percent of people know that antibiotic-resistant bacteria can spread between individuals. Despite ongoing international awareness campaigns, public comprehension remains inadequate regarding viral treatment limits and resistance transmission, underscoring the necessity for multifaceted public awareness strategies and global stewardship.
Antibiotic resistance threatens the future of routine medical procedures and effective infection treatment. Inappropriate use is often driven by public misconceptions, such as using antibiotics for viral illnesses. Identifying where public understanding is deficient allows healthcare systems and policymakers to design targeted communication programmes that curb improper consumption and slow the transmission of resistant bacteria.
The abstract does not indicate an application pathway.
AI-generated from the published abstract. Always read the original work before citing.
BACKGROUND: Antibiotic resistance threatens effective infection treatment and medical procedures. Global initiatives, such as World Antimicrobial Resistance Awareness Week, aim to improve public understanding and promote rational antibiotic use to combat this growing crisis. OBJECTIVE: This systematic review synthesized and analysed existing evidence on the public's knowledge of antibiotic use and resistance to provide pooled global, regional and national estimates. METHODS: A systematic review and meta-analysis. DATA SOURCES: We searched PubMed, Embase, CINAHL, grey literature and reference lists of primary studies. STUDY ELIGIBILITY CRITERIA: Observational studies published between January 2015 and October 2025 that reported the knowledge of antibiotic use and resistance among the public. ASSESSMENT OF RISK OF BIAS: The Joanna Briggs Institute's critical appraisal framework for prevalence studies was used. METHODS OF DATA SYNTHESIS: Pooled estimates of correct knowledge were determined using random-effects meta-analysis. RESULTS: Of the 13 960 articles identified, 227 studies from 98 countries were included. The majority of the public correctly understood that antibiotics are effective against bacterial infections, with a pooled estimate of 73.2% (95% CI, 70.2-76.0). However, only 42.1% (95% CI, 39.2-44.9) recognized that antibiotics are ineffective against viral infections. Notable national variations were observed regarding the ineffectiveness of antibiotics against viral infections, with estimates ranging from 7.2% (95% CI, 5.3-9.7) in Lao People's Democratic Republic (Lao DPR) to 77.0% (95% CI, 74.4-79.4) in Sweden. Our findings indicate that a substantial proportion of the public is aware that unnecessary antibiotic use reduces their effectiveness, with a pooled estimate of 72.5% (95% CI, 69.9-75.0). However, significantly fewer individuals (39.1%; 95% CI, 33.7-44.6) were aware that antibiotic-resistant bacteria can spread from person to person. CONCLUSIONS: Although antibiotic awareness campaigns have expanded globally, public understanding remains insufficient, particularly concerning the ineffectiveness of antibiotics against viral infections and the transmission of antibiotic-resistant bacteria. These findings underscore the need for multifaceted strategies to promote public awareness and advance sustainable antibiotic stewardship worldwide.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1016/j.cmi.2025.11.016
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
