Health Literacy, Antibiotic Use Behaviors, and Awareness of Antimicrobial Resistance Among Patients in Karachi, Pakistan

Background: Antimicrobial resistance (AMR) is a public health problem that is emerging due to inappropriate use of antibiotics and a lack of public awareness. The aim was to evaluate the knowledge, awareness, attitudes, and practices of patients attending a tertiary care hospital in Karachi, Pakistan, regarding antibiotic use and antimicrobial resistance. Methods: A cross-sectional study of 276 adults who had previously used antibiotics was carried out. The health literacy and antibiotic-use knowledge, AMR awareness, knowledge of AMR terminology, antibiotic-use practices, and perceptions of AMR were surveyed with a structured questionnaire. Descriptive statistics and χ 2 tests were used for data analysis. Results: Forty-six percent (46.0%) of the participants had adequate knowledge of antibiotic use while 60.1% had adequate knowledge about AMR. Of those who responded, over half (51.1%) had not heard any terminology related to AMR. About half said they needed help reading instructions from a medical professional. Antibiotic use was prevalent in the past month, experienced by 42.8% of participants. Antibiotic knowledge was significantly associated with education level ( P <0.001), and health literacy ( P =0.010). The attitudes of the participants were positive towards AMR control measures. Conclusion: Knowledge of antibiotic use and AMR is moderate, but there are gaps in knowledge, awareness, and understanding of AMR terminology, and antibiotic-use practices. There is a need for education programs and antimicrobial stewardship measures to encourage prudent use of antibiotics.