An evaluation of knowledge, attitude, and behaviour amongst patients regarding antibiotic use and misuse in an urban setting within South Africa

Abstract

Background: Antibiotic misuse is a major driver of antimicrobial resistance (AMR), a global health threat intensified by limited public awareness and inappropriate community practices. In South Africa, where the burden of infectious diseases remains high, understanding patients’ knowledge, attitudes, and behaviours is essential for informing locally relevant education and stewardship strategies.

Methods: A descriptive cross-sectional study was conducted using a structured, self-administered questionnaire among 135 adult patients attending a community pharmacy in the eThekwini Metropolitan Municipality. Data were analysed using Microsoft Excel and SPSS to generate descriptive statistics and assess associations between socio-demographic variables and antibiotic-related knowledge, attitudes, and behaviours.

Results: While 80% of participants correctly acknowledged that different antibiotics are used for different infections, 73% mistakenly believed antibiotics are effective against viral illnesses. Only 61% recognised antimicrobial resistance as a global concern. Although 77% reported receiving antibiotic counselling from pharmacists and 72% from doctors, misconceptions about appropriate antibiotic use persisted. No statistically significant associations were found between gender, education level, or recent antibiotic use and knowledge or attitudes.

Conclusion: Communication between healthcare providers and patients is occurring; however, significant gaps in public knowledge persist, particularly regarding the inappropriate use of antibiotics for viral infections. To address these misconceptions and reduce antimicrobial resistance, context-specific educational interventions and strengthened provider–patient communication strategies are essential within both public and private healthcare settings in South Africa.