What do we know and how do we act: knowledge, attitude and practices around antimicrobial resistance

Background: The overuse and misuse of antibiotics has influenced a rise in antimicrobial resistance (AMR) thereby posing a significant threat to global health. Information on AMR has been available to the public; however, a gap exists in relay of information due to lack of effective interventions. This study focuses on exploring the knowledge, attitudes and practices (KAP) among rural, semi-urban and urban populations from Delhi NCR, India. Methods: This study was a cross-sectional questionnaire based online survey conducted across rural, semi-urban and urban areas of Delhi NCR for one month (June-July 2024). The questionnaire comprising 28 close-ended questions was administered in English and Hindi languages to participants aged 15-80 years. The questionnaire focused on knowledge, awareness and practices of antibiotics and antimicrobial resistance. Results: A total of 500 participants attempted the survey out of which 435 (87%) were aware about antibiotics. About 479 (95.8%) participants had earlier consumed antibiotics out of which 336/497 (70.1%) participants consumed antibiotics prescribed by doctors. Among 479 participants, 253 (52.8%) completed the course however 311 (69.1%) of the participants kept the antibiotics for reuse. Nearly 191/479 (39.9%) participants practiced antibiotics misuse by consumption of antibiotics when having similar symptoms as previously observed. The assessment of participants revealed that only 216/500 (43.2%) participants were knowledgeable about AMR. The participants aware of AMR agreed that the antibiotic practices of reuse (n=69/216, 31.9%), poor quality (n=87/216, 40.3%), lower dosage (n=81/216, 37.5%) and not completion of course (n=77/216, 35.6%) can result in AMR. Conclusions: The study highlights that despite the participants being informed about antibiotics and followed medical advice their practice of reusing antibiotics raises the need for tailored interventions to promote awareness about AMR and appropriate use of antibiotics.