Knowledge, perception, and behaviours related to antibiotic use and antimicrobial resistance in community-dwelling individuals in Hong Kong

Background: Understanding public knowledge and behaviours related to antibiotics and antimicrobial resistance (AMR) may inform interventions to reduce inappropriate antibiotics use. Methods: We conducted a questionnaire survey in community-dwelling adults in Hong Kong from 2020 to 2022 to examine knowledge, risk perception on AMR and antibiotics, and behavioural patterns in antibiotic use. Information on demographics, socioeconomic status and general health was examined in relation to the knowledge score, antibiotic use behaviours and preference for antibiotic-free food products in regression models. Results: Of the 1147 participants, the median knowledge score on AMR and antibiotics was 13 (interquartile range (IQR): 9-17 out of 24). Females (knowledge coefficient:-0.95; 95 % confidence interval (CI):-1.65,-0.26) and those aged >= 65 years (-1.91;-2.85,-0.98) had a relatively lower score. Over 94 % of antibiotic users reported strict adherence to prescriptions, while most non-compliant users kept unused antibiotics for future use (45/66, 68.2 %). Presence of chronic diseases was associated with antibiotic use in the past year (odds ratio (OR): 1.65; 95 % CI: 1.20, 2.29). A higher socioeconomic status or knowledge score predicted a better awareness of and preference for antibiotic-free food and stronger belief in AMR-related threats while older age was associated with lower awareness of antibiotic-free food and perceived risk of AMR. Conclusions: The lack of AMR-related knowledge and potentially higher antibiotics exposure, particularly in older, less educated, socioeconomically underprivileged individuals, highlighted the need for improving targeted education and risk communication on AMR in the public.