Household Knowledge of Clinical Risks, Storage, and Disposal of Leftover Antibiotics: A Multinational Study in Seven Developing Countries

In this cross-country survey of 3,191 adults from seven developing countries, the authors investigate how households handle leftover antibiotics — assessing knowledge about clinical risks, and practices around storage and disposal. The study finds major gaps between what people know and what they actually do: a substantial proportion of respondents lacked adequate awareness of the dangers of inappropriate antibiotic use, including the risk of antimicrobial resistance (AMR), and many admitted to storing leftover antibiotics at home or disposing of them improperly.

Practices such as keeping leftover antibiotics for later use, sharing them with family members, or self-medicating without professional guidance were common, increasing the likelihood of misuse. This behavior is a recognized driver of resistance globally, particularly in settings with loose prescription enforcement and limited access to diagnostic or health care services. The widespread retention of antibiotics at home also raises concerns for public and environmental health: improper storage conditions may degrade drug quality, and unsafe disposal may release residues into water or soil, contributing further to environmental exposure and selection for resistance. Comparable research in other countries has shown similar trends — many households store antibiotics for future use, self-medicate, or dispose of expired medicines through regular trash, highlighting this as a pervasive global problem.

The authors conclude that reducing AMR will require more than prescribing guidelines; it demands public education to improve awareness about risks of leftover antibiotic use, safe storage, and disposal — combined with stricter regulation of antibiotic sales, and improved access to healthcare and diagnostics.