Reducing the growth of antimicrobial resistance (AMR) through public understanding is a goal of the World Health Organization. It is especially important in countries where antibiotics are widely available for common ailments without prescription. This study assessed understanding of antibiotics and AMR alongside perception of antibiotic usage among the general public in two diverse Sri Lankan communities: ordinary urban and indigenous rural. A cross-sectional questionnaire survey was conducted, gaining 182 urban and 147 rural responses. The majority of urban respondents (69.2%) believed that they had very good or good knowledge about antibiotics compared to 40.1% of rural respondents. Belief about knowledge and actual knowledge (measured via a test question) were correlated (r = 0.49, p = 0.001) for rural respondents, but not for urban respondents. Several misconceptions about antibiotics were highlighted, including that Paracetamol, a painkiller, was thought to be an antibiotic by more than 50% of both urban and rural respondents. In addition, 18.5% of urban and 35.4% of rural participants would keep and re-use what they perceived as leftover antibiotics. It is urgent that we pay attention to educating the general public regarding the identified misconceptions of these powerful drugs and their appropriate use.
Keywords: Sri Lanka; antibiotics; antimicrobial resistance; awareness; knowledge; perceptions; rural community; urban community.