Improving Antibiotic Stewardship and Antimicrobial Resistance Awareness Through Community and Digital Health Interventions

Abstract

Background: Antimicrobial resistance (AMR) is a major global health threat driven largely by inappropriate antibiotic use in community settings.

Objective: To assess antibiotic stewardship practices, AMR awareness, and the impact of community-based and digital health interventions among mothers and caregivers.

Methodology:  A community-based mixed-methods study was conducted in Lahore (January–June 2025) among 425 mothers and caregivers recruited from healthcare facilities and through digital platforms. Data were collected using a pretested questionnaire, interviews, and focus group discussions to assess antibiotic use, AMR awareness, and exposure to community and digital interventions. Quantitative data were analyzed using SPSS version 26 with descriptive statistics, chi-square test, and multivariate logistic regression, while qualitative data were analyzed thematically.

Results: Among 425 participants, self-medication was reported by 41.41% (n = 176), non-prescription antibiotic purchase by 37.18% (n = 158), and leftover antibiotic use by 28.00% (n = 119), while only 53.88% (n = 229) completed full antibiotic courses. Overall, 53.65% (n = 228) of participants demonstrated awareness of AMR. Community education exposure was significantly associated with better stewardship (68.87%, n = 146 vs 48.36%, n = 103; p < 0.001), and digital health exposure was significantly associated with higher AMR awareness (61.32%, n = 176 vs 37.68%, n = 52; p < 0.001). Key predictors of inappropriate antibiotic use included low education (AOR = 2.68), poor AMR awareness (AOR = 3.12), and lack of digital health exposure (AOR = 2.21).

Conclusion: Antibiotic misuse and limited AMR awareness remain common, while community and digital health interventions significantly improve stewardship behaviors.