Patterns and Predictors of Antibiotic Misuse Among Rural Households: Implications for Antimicrobial Resistance Control in Rural Bangladesh

Background: Antibiotic misuse is a major contributor to antimicrobial resistance (AMR), particularly in rural South Asia, where limited healthcare access and self-medication practices are common. Objective: This study investigates patterns and predictors of antibiotic misuse among rural households in Sagardari Union, Keshobpur Upazila, Jashore District, Bangladesh. Methods: A community-based cross-sectional study was conducted with 300 households from January to December 2024. Data was collected using structured interviews with adult respondents. Socio-demographic characteristics, knowledge about antibiotics and AMR, and patterns of antibiotic use (including non-prescription use, storage of leftover antibiotics, and completion of courses) were assessed. Chi-square tests and logistic regression were used for data analysis. Results: Among the respondents, 66% reported using antibiotics in the past six months, with 42% using them without prescriptions. 37.3% of households stored leftover antibiotics at home. Knowledge about antibiotics was insufficient, with 62% aware of their role in treating bacterial infections, but only 22% had heard of AMR. Significant predictors of antibiotic misuse included no formal education (AOR=3.12), low income (AOR=2.45), and poor knowledge about antibiotics (AOR=4.21). Conclusion: Antibiotic misuse in rural Bangladesh is prevalent and strongly influenced by education, income, and knowledge about antibiotics. Public health interventions aimed at increasing awareness about AMR, regulating antibiotic sales, and improving health literacy in rural areas are critical in combating AMR and promoting appropriate antibiotic use.