Public knowledge and perception about antimicrobials and antimicrobial resistance in Japan: A national questionnaire survey in 2017

PLoS One. 2018 Nov 5;13(11):e0207017. doi: 10.1371/journal.pone.0207017. eCollection 2018.


Background: Antimicrobial resistance (AMR) is a threat to global health. To increase public awareness about AMR and encourage the prudent use of antimicrobials is one of the goals of the National Action Plan in Japan.

Methods: A nationwide online cross-sectional survey was conducted to evaluate the existing knowledge and perception of AMR in Japan, based on the Antimicrobial Resistance Eurobarometer Survey. Participants included Japanese adults aged 20-69 years, who were not medical professionals.

Results: Among a total of 3,390 participants, about half had taken antibiotics over the past 12 months, and majority of them obtained the antimicrobials from healthcare institutions for the common cold. While 11.7% of the participants kept leftover antibiotics, 23.6% of them have adjusted doses by themselves. About 10% of the participants have requested antibiotics from their doctors, and nearly 30% of them preferred doctors who prescribed antibiotics when had a cold. The common informational sources were TV news and newspapers, and more than 40% of the participants reported receiving some information over the past year. However, approximately 80% of the participants did not know that antibiotics do not kill viruses and that antibiotics are ineffective against cold and flu.

Conclusion: Not many Japanese have adequate information about antimicrobials and AMR, and many have taken antimicrobials inappropriately. Greater educational interventions are, therefore, necessary to increase public awareness and develop effective countermeasures against AMR in Japan.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents / therapeutic use*
  • Common Cold / drug therapy
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Internet
  • Japan
  • Male
  • Middle Aged
  • Perception
  • Prescriptions
  • Surveys and Questionnaires
  • Young Adult


  • Anti-Infective Agents

Grant support

This work was supported by Health and Labour Sciences Research Grants (Research on Emerging and Re-emerging Infectious Diseases and Immunization) in fiscal year 2016, Ministry of Health, Labour and Welfare, Japan (In Japanese Site) ( The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.