Year 2021
October 2021


Abstract Title
Predisposing factors influencing inappropriate antibiotics use amongst Singapore residents: A nationally-representative cross-sectional study



Tan Tock Seng Hospital1

Background & Hypothesis

Antibiotic misuse and overuse are major drivers of antimicrobial resistance (AMR). Understanding predisposing factors influencing inappropriate antibiotics use amongst Singapore residents can guide the design of targeted interventions to improve antibiotic use practices and reduce AMR in Singapore.


We conducted a nationally-representative cross-sectional population survey between November 2020 and January 2021 on a proportional stratified random sample of adult Singapore residents. Inappropriate antibiotics use was defined as agreement with any of 6 negative proxy statements from the US Centers for Disease Control and Prevention’s public advisory on antibiotics use. Knowledge on antibiotics use and AMR were computed from 3 and 8 statements, respectively, from the World Health Organization’s Antibiotic Resistance: Multi-country Public Awareness Survey questionnaire. Participants were deemed to be knowledgeable if they answered correctly to all statements.


A total of 2004 members of the public participated in the study. Males (aOR 1.55, 95% CI 1.22-1.96, P<0.001), younger age groups (35-49 years [aOR 1.50, 95% CI 1.11-2.02, P=0.008]; 21-34 years [aOR 2.34, 95% CI 1.67-3.28, P<0.001]), non-Chinese (aOR 1.40, 95% CI 1.06-1.85, P=0.018), lower educated (aOR 1.73, 95% CI 1.28-2.34, P<0.001), non-healthcare-related professionals (aOR 1.93, 95% CI 1.05-3.56, P=0.034), individuals who lacked knowledge of antibiotics use (aOR 4.18, 95% CI 3.22-5.43, P<0.001) or knowledge of AMR (aOR 3.89, 95% CI 1.91-7.90, P<0.001) tended to use antibiotics inappropriately.

Discussion & Conclusion

Empowering Singapore residents with knowledge of antibiotics use and AMR can reduce inappropriate antibiotics use. Targeted educational interventions for specific socio-demographic groups should be employed.