A Silent Siege: Knowledge, Attitudes, and Practices Regarding Antibiotic Use and Antimicrobial Resistance Among Patients Attending a Tertiary Care Hospital in Lahore, Pakistan

Abstract

Background: Antimicrobial resistance (AMR) is considered as one of the greatest public health and modern medicine threats. This bacterial AMR is responsible for millions of deaths world-wide.

Objectives: To measure the knowledge, attitude and practices in the use of antibiotics and antimicrobial resistance among patients of a tertiary care hospital.

Methods: This is an analytical cross-sectional study on a sample of Central Park Teaching Hospital Lahore, Pakistan from October 2025 to March 2026. The technique used in recruiting participants was non-probability consecutive sampling. 225 adult patients visiting the outpatient department and ward of the hospital were selected. The data were obtained by using a structured interviewer-administered questionnaire. A score of ≥60% of the items was considered a good knowledge. The data were analysed with SPSS version 29. The following statistical methods were used: frequencies, percentages, mean ± standard deviation, chi-square test and logistic regression. A p-value ≤0.05 was considered statistically significant.

Results: Mean age was 36.8 ± 12.6 years. Good knowledge was noted in 94(41.8%) and poor knowledge was noted in 131(58.2%). 86(38.2%) correctly identified that antibiotics will not help with viral infections. Self-medication was reported by 105(46.7%) participants and 88(39.1%) discontinued antibiotics after they felt better. Higher education was significantly associated with good knowledge (p=0.002). Poor knowledge was significantly linked with self-medication (p=0.004), early discontinuation (p=0.011), leftover antibiotic use (p=0.009) and purchase of antibiotic without prescription (p=0.006). Higher education (AOR 2.4; 95% CI 1.4–4.2) and urban residence (AOR 1.8; 95% CI 1.1–3.1) independently predicted the good knowledge of participants.

Conclusion: Many patients lacked knowledge about antibiotic usage and antimicrobial resistance. Unsafe use of antibiotics was frequent and was significantly associated with poor knowledge. To encourage rational use of antimicrobials, interventions in public education, prescription regulation and antimicrobial stewardship are needed.