Poor health knowledge and behaviour is a risk for the spread of antibiotic resistance: survey of higher secondary school students in Goa, India.

Aims: We assessed antibiotic knowledge and practice among youth in India, where antibiotics are widely available without prescription.

Methods: Randomly selected school questionnaire survey representing four regions in Goa, India, with students ( n = 773) aged 16-17.

Results: Most students (67%) were unaware of the problem of antibiotic resistance, with around half (49%) mistakenly thinking that bacteria cause cold or flu. Around one-fifth (19%) said they frequently self-medicate with antibiotics, 57% would discontinue antibiotics when symptoms alleviated and 24% stored unused antibiotics at home. Generalised linear mixed models (GLMM) showed that females consistently had poorer antibiotic knowledge than males. Especially notable were the higher odds in females for reporting incorrectly that antibiotics kill harmful viruses (odds ratio (OR) = 1.93; 99.5% confidence interval (CI) = 1.09-3.41) and for reporting incorrectly that antibiotics do not kill harmless bacteria (OR = 2.02; 99.5% CI = 1.16-3.51). Poor antibiotic practice was not clearly differentiated between males and females. In terms of poor antibiotic practice, one model showed notable results for educational stream: both arts and commerce students were more likely than science students to say they would discontinue antibiotics when symptoms alleviated and before the antibiotic course of treatment was finished (arts: OR = 2.76; 99.5% CI = 1.58-4.82 and commerce: OR = 1.79; 99.5% CI = 1.06-3.04).

Conclusion: Young adults in India had poor antibiotic knowledge and practice. Efforts to improve antibiotic health knowledge and safe practice are required to help prevent the spread of antibiotic resistance.