Work

The public’s irrational use of antibiotics for upper respiratory tract infections: a cross-sectional study based on the health belief model

Year: 2025

Type: article

Abstract: To understand the reasons for the public's irrational use of antibiotics based on the health belief model (HBM). A questionnaire survey was conducted based on cluster random sampling in Chongqing, China. The public's antibiotic use behaviors, knowledge, perceived threat of diseases [both short-term upper respiratory tract infections (URTIs) and long-term antibiotic resistance (AR)], perceived value of antibiotic use (benefits and harm), self-efficacy, antibiotic availability and social influences were measured. Structural equation modeling (SEM) was applied to test the fitness of the survey data with the theoretical framework based on the HBM. A total of 815 respondents were enrolled. The irrational use of antibiotics was prevalent among the public (mean: 2.95, SD = 2.12). The public had limited knowledge about antibiotic use (average 29.17% correct answers to 8 questions), a high perceived threat of AR (mean = 2.46, SD = 0.64) and a moderate perceived threat of URTIs (mean = 2.13, SD = 1.04). They also perceived high benefits (mean = 2.57, SD = 0.68) and moderate harm (mean = 2.16, SD = 0.83) from antibiotic use. In addition, respondents had easy access to antibiotics (mean = 2.38, SD = 0.80), perceived a high prevalence of use of antibiotics by relatives (mean = 2.40, SD = 0.65) and had a moderate level of self-efficacy in using antibiotics (mean = 1.97, SD = 0.75). The SEM results showed that higher levels of the perceived threat of URTIs, perceived benefits of antibiotic use, self-efficacy, antibiotic availability and social influence were associated with more irrational antibiotic use behavior (p < 0.005). Moreover, higher knowledge indirectly led to irrational use of antibiotics by promoting self-efficacy (p < 0.001) and the perceived threat of URTIs (p < 0.005). To curb the irrational use of antibiotics, improving knowledge alone is insufficient. A systematic approach addressing multiple dimensions of health beliefs is critical. This includes: (1) targeted public education campaigns emphasizing the limited efficacy of antibiotics for viral infections and reframing perceptions of antibiotic "benefits"; (2) regulatory measures to restrict non-prescription antibiotic sales in pharmacies; (3) clinical guidelines and training to reduce unnecessary antibiotic prescriptions by healthcare providers; and (4) community-level interventions leveraging social norms to discourage inappropriate antibiotic use. Policymakers should prioritize interventions that address both individual perceptions (e.g., fear of untreated infections) and systemic drivers (e.g., antibiotic accessibility).

Source: Scientific Reports

DOI: 10.1038/s41598-025-01767-9