Combatting antimicrobial resistance amidst the era of economic crisis: Public perceptions and antibiotic practices in Lebanon.

Background: The misuse of antibiotics is fueling antimicrobial resistance (AMR), a critical public health threat. In settings of severe economic crisis, these challenges are often amplified, impacting public access to and appropriate use of medications. This study assessed the knowledge, attitudes, and practices (KAP) of the Lebanese population regarding antibiotic use and AMR, contextualized within the nation's ongoing economic crisis. Design and Methods: A cross-sectional study was conducted from July to December 2023 using an anonymous questionnaire distributed online and in-person across Lebanon. Data were analyzed using Results: Among 409 participants, significant knowledge gaps and common misconceptions were evident: only 44.74% knew antibiotics are ineffective against viruses, just 24.69% recognized the lethality of AMR, and many incorrectly used antibiotics for a fever (36%) or cough (26.41%). Critically, these knowledge gaps translated into high-risk behaviors shaped by the economic crisis; 42.06% reported financial constraints influenced their antibiotic use, leading to cost-avoiding practices like using leftover medications (41.81%) and sharing them (31.05%). Demographically, higher educational levels and female gender were associated with better knowledge ( Conclusions: This study reveals a dual challenge in Lebanon: widespread misconceptions about antibiotics are compounded by economic pressures that shape patient behavior. Our findings indicate that financial constraints directly influence antibiotic access and self-medication practices. Therefore, effective interventions require a two-pronged approach: strengthening public health education to address knowledge gaps, while simultaneously developing policy solutions to ensure equitable antibiotic access and mitigate the impact of economic hardship on appropriate use and the fight against AMR.