What You Need to Know
While most people know antibiotics treat bacterial infections, less than half understand they are not effective against viral illnesses like colds and flu, and this misconception has not improved in a decade.
A majority recognize that misuse drives resistance and that completing prescribed courses is important, yet only about 58% see antibiotic resistance as a global public health threat.
Despite widespread awareness campaigns, knowledge gaps remain significant, prompting researchers to call for more targeted, multifaceted public health strategies to clarify the differences between bacterial and viral infections and curb inappropriate antibiotic use.
Auta and colleagues determined that an estimated 73.2% (95% CI, 70.2%-76.0%) of participants recognize antibiotics are effective in treating bacterial infection. Although they found no significant variations across broad world regions, there were significant differences between countries. The variance ranged from 15.7% in Sri Lanka (range, 12.1%-20.1%) to 88% (range, 85.7%-90.0%) in Norway.
In contrast to the broadly held understanding that antibiotics are utilized for bacterial infection, the pooled global estimate of those understanding that they are ineffective against viral infection was 42.1% (range, 39.2%-44.9%). The investigators noted that these estimated percentages were, again, relatively consistent across world regions but with significant intracountry differences and higher percentages of correct understanding in Europe and Central Asia (49.8%; range, 46.2%-53.5%) and in North America (62.2%; range, 52.4%-71.9%).
The investigators found that most of the general population (72.5%; range, 69.9%-75.0%) were aware that unnecessary use of antibiotics contributes to the development of resistance and their subsequent ineffectiveness. They also found most (67.9%; range, 64.5%-71.2%) understand the importance of completing an antibiotic regimen despite early improvement of symptoms. Antibiotic resistance was recognized as a global public health threat by 58.4% (range, 49.1%-67.8%).
Auta and colleagues noted that their finding that most persons incorrectly understand that antibiotics can be used for colds and influenza is consistent with a global systematic review2 published in 2015, which reported that the misunderstanding was then held by 53.9% (range, 41.6%-66.0%) of the public.
"This suggests that public understanding of this outcome has remained unchanged over time," they observed. "This persistent misconception will continue to drive the misuse of antibiotics for viral infections."
The investigators attribute the low levels of public knowledge that antibiotics are ineffective against viral infection partially to the overlap in symptoms and to using antibiotics for self-limiting respiratory infections and associating recovery with the antibiotic.
"To address these misconceptions, public health initiatives should focus on improving education among the general population regarding the differences between bacterial and viral infections, the risks of unnecessary antibiotic use, and the global impact of antibiotic resistance," they recommended.
References
1. Auta A, Adewuyi EO, Hedima EW, et al. Global and regional knowledge of antibiotic use and resistance among the general public: a systematic review and meta-analysis. Clin Microbiol Infect. Published online November 22, 2025. doi:10.1016/j.cmi.2025.11.016
2. Gualano MR, Gili R, Scaioli G, Bert F, Siliquini R. General population's knowledge and attitudes about antibiotics: a systematic review and meta-analysis. Pharmacoepidemiol Drug Saf. 2015;24(1):2-10. doi:10.1002/pds.3716
