Does education attainment affect the knowledge, attitude and practices of antibiotics and antibiotic resistance among Chinese public?

Abstract Background: Antibiotic resistance has become a serious global public health threat this century. This study aimed to assess knowledge, attitudes, and practices (KAP) towards antibiotics and antibiotic resistance among the public at different education attainment. Methods: This cross-sectional study was conducted in China from November 2020 to April 2021. Knowledge, attitude and practices of antibiotics and antibiotic resistance were assessed using a self-administered questionnaire. The questionnaire included sociodemographic characteristics, KAP for antibiotics and antibiotic resistance. Linear regression analysis and XGBoost models were employed to identify factors associated with KAP of antibiotics and antibiotic resistance. Results: A total of 3,135 respondents completed the questionnaire, of which there were slightly more respondents with a college degree and above (1697, 54.1%) than those with a below college degree (1438, 45.9%). Respondents’ knowledge, attitude, and practices concerning antibiotics and antibiotic resistance remained at a moderate level. Both linear regression analysis and XGBoost models revealed that education attainment was significantly associated with KAP of respondents. Respondents with higher education attainment exhibited better knowledge, a more positive attitude, and more rational practices regarding antibiotics and antibiotic resistance. Conclusion: The insufficient KAP of the public towards antibiotics and antibiotic resistance may lead to an increase in irrational antibiotic use. It is necessary to enhance public education on antibiotics and antibiotic resistance by diversifying the forms of education.