The rapid escalation of antimicrobial resistance (AMR) has made it one of the defining global health emergencies of our time, a crisis fuelled to no small extent by the systemic overuse and misuse of antibiotics in the population. Even with public health authorities making inroads through various campaigns, rates of self-medication, the premature ending of a course of treatment, and the use of antibiotics for viral ailments are still unacceptably high. This paper sets out to examine the complex interplay of public awareness and the health risks of antibiotic misuse, mapping the cognitive and socioeconomic factors that underpin such dangerous habits.
We have used a mixed-methods approach to get at both the statistical picture and the more subtle individual motivations. Our quantitative arm involved a survey of 1,250 people from diverse demographic backgrounds; the data were put through a battery of statistical tests, including confirmatory factor analysis and hierarchical multiple regression, to determine how much health literacy predicts consumption. To round this out, we conducted 60 semi-structured interviews with pharmacists, healthcare workers and members of the community, applying thematic analysis to their transcripts to identify socio-cultural impediments to proper medical compliance. What the evidence shows is a paradox: although there has been some improvement in the general recognition of the phrase ‘antibiotic resistance’, functional knowledge of how to use these drugs is wanting. More than 70% of those surveyed held the false view that antibiotics will cure a virus, while financial pressures often led to unregulated purchases from the pharmacy.
Our regression work points to a strong inverse relationship between targeted health literacy and the inclination to self-medicate (β = -0.62, p < 0.001). We argue that the old model of information-heavy awareness drives is not enough. Public health policy needs to be reoriented toward community-level interventions that tackle the structural and cognitive roots of the problem. In so doing, this research offers an evidence base for better antimicrobial stewardship on a global scale.