Despite the global expansion of antibiotic awareness campaigns over the past decade, the public's understanding of antibiotics remains insufficient, researchers reported last week in Clinical Microbiology and Infection.

In a systematic review and meta-analysis, researchers from Australia, Nigeria, and the United Kingdom identified 227 studies from 98 countries that reported the knowledge of antibiotic use and resistance among the public. They found that 73.2% of the 322,492 participants correctly recognized that antibiotics are effective in treating bacterial infections and 72.5% knew that excessive antibiotic use reduces the effectiveness of antibiotics.

But only 42.1% knew that antibiotics were not effective against viruses, and that number was significantly lower in countries such as Laos (7.2%), Myanmar (11.7%), and Bangladesh (12.5%). Similarly, only 35.1% of respondents knew that antibiotics don't speed up recovery from cold and flu. 

The study authors note that a systematic review conducted in 2015—the year the World Health Organization declared antimicrobial resistance (AMR) a top 10 global health threat—reported that 46.1% of the public was aware that antibiotics are ineffective against viruses, which suggests a decade of public awareness campaigns has had little impact.

"This persistent misconception will continue to drive the misuse of antibiotics for viral infections, a widespread issue in many regions globally, thereby contributing to the broader challenge of AMR," they wrote. "The low levels of public knowledge regarding the ineffectiveness of antibiotics against viral infections suggest that current efforts and campaigns aimed at addressing antibiotic resistance remain insufficient."

Multifaceted strategies are needed

In addition, while 58.4% of respondents acknowledged antibiotic resistance as a global health threat, only 39.1% understood that antibiotic-resistant bacteria can be transmitted between individuals.

"Understanding that resistant bacteria can be transmitted from person to person is crucial, as interpersonal spread represents a key mechanism by which antimicrobial resistance propagates within communities," the authors wrote.

The authors conclude that multifaceted strategies are needed to enhance public knowledge of antibiotics.

"These strategies should include patient education by healthcare professionals, targeted outreach, mass media and digital campaigns, formal education, community-based interventions, robust policy and regulatory measures, and international collaboration," they wrote.