Significant gaps in practise present despite higher level of public awareness in Antibiotic Use and Antimicrobial Resistance in the western province of Sri Lanka

Background: Antibiotic misuse, influenced by urbanization and limited healthcare access, has accelerated antibiotic resistance, impacting global health. Surveillance in Sri Lanka's National Strategic Plan for Combating Antimicrobial Resistance (2017-2022) shows significant multi-drug resistance in hospitals, with 12.7% of the health budget (3.3 billion) spent on antimicrobials. This resistance complicates treatment and increases patient management costs, particularly in the Western Province, a focal area for analyzing antibiotic misuse.   Objectives: To assess public awareness of antibiotic misuse and antimicrobial resistance in the Western Province of Sri Lanka. Methodology: A cross-sectional study was conducted on 200 adults in the Western Province from December 23, 2023, to January 16, 2024, using in-person interviews and a Google form questionnaire. Descriptive statistics were applied to analyze the data.   Results: Of the respondents, 83% knew antibiotics combat bacterial infections, while 71.5% adhered to completing antibiotic courses. However, 28.5% opposed doing so, with 65.5% stopping antibiotics once they felt better. Regarding antimicrobial resistance, 60.5% recognized the term, and 61% acknowledged that unnecessary antibiotic use could increase bacterial resistance. Conclusion: Most participants understood antibiotics' role, though gaps in correct use and awareness of misuse consequences persisted. While there was a positive attitude toward antimicrobial resistance, further educational efforts are essential to address knowledge gaps, as recent studies show high resistance levels and limited progress in awareness. Keywords: AMR; Antibiotic resistance; antimicrobial resistance; Knowledge; Awareness; Sri Lanka