Awareness of Antimicrobial Resistance and Antibiotic Use Among Patients Attending the Outpatient Department of a Tertiary Care Hospital

Introduction: Antimicrobial resistance (AMR) is an increasing global public health problem that threatens the effective prevention and treatment of infectious diseases. Inappropriate antibiotic use, including self-medication, premature discontinuation of therapy, and misuse for viral infections, plays a major role in the development and spread of AMR. The increasing occurrence of multidrug-resistant organisms and the limited availability of effective antibiotics have further worsened this problem. Aim: To assess the knowledge, attitudes, and practices related to antibiotic use and antimicrobial resistance among patients attending the outpatient department of a tertiary care hospital; to identify common factors contributing to inappropriate antibiotic use, such as self-medication and incomplete antibiotic courses; and to determine the association between demographic variables and the knowledge, attitudes, and practices related to antibiotic use and antimicrobial resistance during the study period. Methodology: This hospital-based cross-sectional study was conducted among adult outpatients of a tertiary care hospital over four months. Consecutive sampling was conducted in 259 participants (137 were females [52.9%] and 122 males [47.1%]). Data were collected using a pre-validated questionnaire assessing knowledge, attitudes, and practices related to antibiotic use and antimicrobial resistance. The data were analyzed using IBM Corp. Released 2025. IBM SPSS Statistics for Windows, Version 31. Armonk, NY: IBM Corp. with descriptive statistics and Pearson chi-square tests, considering p < 0.05 as statistically significant. Results: Awareness of antibiotics was reported by 241 participants (93.1%), but only 93 (35.9%) correctly identified that antibiotics treat bacterial infections only, while 132 (51.0%) believed they treat both viral and bacterial infections. Awareness of antimicrobial resistance (AMR) was reported by 151 (58.3%), and 127 (49.0%) correctly understood antibiotic resistance as resistance of microorganisms. Regarding attitudes, 174 participants (67.2%) reported that taking antibiotics without a prescription is unacceptable. Antibiotics should not be stopped once symptoms improve was reported by 134 (51.7%) . In terms of practices, 49 (18.9%) reported self-medication, and 78 (30.1%) reported not completing prescribed antibiotic courses. Pearson Chi-square analysis showed that education level was significantly associated with knowledge and attitudes toward antibiotic use and antimicrobial resistance (χ² = 36.437, p ≤ 0.05). Gender showed a significant association with beliefs regarding stopping antibiotics early (χ² = 12.850, p = 0.005), while age and residence were not significantly associated (p > 0.05). Conclusion: The study highlights a clear gap between awareness, knowledge, and actual practices related to antibiotic use among outpatient attendees. Although most participants had heard of antibiotics, misconceptions regarding their indications and antimicrobial practices, with self-medication and incomplete antibiotic courses remaining common. Educational level emerged as the most influential factor affecting antibiotic-related knowledge and attitudes. These findings emphasize the need for targeted educational programs, improved patient counseling during outpatient visits, and stricter enforcement of prescription-only antibiotic policies to promote rational antibiotic use and reduce antimicrobial resistance.