Knowledge and perceptions of community members on antimicrobial use and resistance in Cross River State, Nigeria

The study surveyed 483 community members across several local government areas in Cross River State, Nigeria (Nov 2023–Jan 2024), to assess their knowledge, experiences and attitudes regarding antibiotic use and antimicrobial resistance (AMR). They found that 73.1% of respondents had used antibiotics — and 40.9% had used them 2–5 times in the past year. While about 65.0% demonstrated what the authors qualify as “good knowledge” of AMR (for example recognizing correct antibiotic types and understanding risks), many misconceptions persisted: 60.2% believed antibiotics work against colds, and 51.7% thought it was safe to stop antibiotics once they felt better. Moreover, although 58.8% had a positive attitude toward preventing AMR, a large majority (71.0%) reported that they save or share leftover antibiotics — practices that promote misuse and resistance. Importantly, knowledge and attitudes varied significantly with socio-demographic factors: employment status correlated with better knowledge and perceptions (p = 0.001 and p < 0.001, respectively), while lower education levels correlated with more negative perceptions (p < 0.001). The authors conclude that — despite some awareness and trust in healthcare providers — misconceptions and informal antibiotic-use practices remain widespread, and they recommend targeted education and regulatory enforcement, especially focusing on informal drug markets and lower-literacy populations, within a broader One Health framework.