An interventional study to assess improvement in knowledge attitude and practice on antimicrobial use and resistance among rural community in Tamil Nadu, India

• Author Details:   
• Sujin Padmanabhan ^*
• Valarmathi Balakrishnan
• Savitha Govindarajan
• Saranya Loganathan Kumaresan
• Sendilkumar Balasundaram
• Gayathri Kumar

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Background: In rural Indian communities, misuse of antibiotics contributes significantly to rising antimicrobial resistance (AMR). A village in South India was chosen as it represents a typical setting where patterns of antibiotic use remain suboptimal due to low awareness and improper access.

Aim and Objective: To evaluate the knowledge, attitude and practice related to antibiotic use and resistance, effectiveness of a structured community-based educational intervention on improving the community knowledge and to measure changes between pre‑ and post‑intervention phases.

Materials and Methods: A quasi‑experimental pre‑post study was conducted from August 2024 to January 2025 in Kalaiyur village which was taken as the intervention group and another village nearby with the same characteristics was chosen to be control group. Baseline KAP data were collected using a validated questionnaire covering awareness of antibiotics, proper indications, consequences of misuse, adherence, and resistance. An intervention package comprising pamphlets, lecture, placards, and street plays in Tamil, was delivered over four weeks. The same questionnaire was administered six weeks post‑intervention. Data were analysed using paired t‑tests and McNemar’s test; significance was set at p < 0.05.

Results: Before intervention, both the groups had approximately the similar knowledge, attitude and practices, the intervention group showed an improvement in all the three domains after the multicomponent interventions was applied. The DiD analysis showed a spike of 4.0, 2.2 & 2.7 in knowledge, attitude and practices scores respectively after the intervention was applied.

Conclusion: A targeted, culturally-tailored educational intervention significantly improved knowledge, attitudes, and practices significantly about AMR in Kalaiyur village. These results underline the potential of community-level programs to combat antibiotic misuse. Scaling such initiatives across rural India could be a cost-effective step toward AMR containment.