Antibiotic Use, Misconceptions, and Knowledge Gaps Among the Sri Lankan Public: A Multi-Center Cross-Sectional Survey

Background: Antimicrobial resistance (AMR) is a critical public health challenge globally, driven in part by inappropriate antibiotic use and limited public awareness. In Sri Lanka, understanding the public’s knowledge and practices regarding antibiotics and AMR is essential to inform public health interventions aimed at curbing resistance. The aim of this study was to investigate antibiotic use, knowledge of appropriate antibiotic use and AMR among the Sri Lankan public. Methods: A descriptive multi-center cross-sectional study of 1,520 participants from four Sri Lankan hospitals used a validated questionnaire to assess demographics, antibiotic use, and AMR knowledge. Chi-squared tests examined associations between knowledge and demographic variables. Results: Over half of the participants (56.2%) reported antibiotic use within the past year, with many showing misconceptions about proper antibiotic use. Key misunderstandings include the appropriateness of antibiotics for viral infections (51%) and discontinuing antibiotics upon feeling better (58.4%). Only 41.1% reported being aware that antibiotics prescribed for others should not be shared. Individuals who had attained a college or university-level education demonstrated significantly greater knowledge about antimicrobial resistance (AMR) and appropriate antibiotic use compared to those with lower levels of education(p=0.000). Conclusion: This study highlights critical gaps in public understanding of antibiotics and AMR in Sri Lanka, particularly among those with lower education levels. These gaps underscore the need for targeted educational initiatives and strengthened antimicrobial stewardship programs to promote rationale antibiotic use. Addressing these misconceptions through accessible public health campaigns could significantly contribute to the reduction of AMR in Sri Lanka.