ORIGINAL RESEARCH Knowledge and Reported Use of Antibiotics Amongst Immigrant Ethnic Groups in New Zealand Pauline Norris Æ Lye Funn Ng Æ Victoria Kershaw Æ Fady Hanna Æ Angela Wong Æ Meghna Talekar Æ Jin Oh Æ Maryam Azer Æ Lynn Cheong Published online: 13 January 2009 Ó Springer Science+Business Media, LLC 2009 Abstract Background Over-use and misuse of antibiotics are major causes of antibiotic resistance. This study explored the understanding and reported use of antibiotics amongst three ethnic groups in New Zealand. Methods Questionnaire survey of 300 Indian, Egyptian, and Korean people. Results Most people (73.3%) knew that antibiotics killed bacteria, but other incorrect responses were also common. A range of medicines were mistakenly identified as antibiotics. Nearly half the sample (43.3%) believed colds and flu were caused by bacteria. Only 45.4% were sure that antibiotics were not useful for colds and flu. A minority of participants knew about antibiotic resistance. There were significant differences between groups, with Koreans having lower levels of understanding. Discussion Interventions to improve use of antibiotics need to be pit- ched at a very basic level of knowledge, and need to be targeted towards particular ethnic groups, particularly those in whose home countries antibiotics are widely available without prescription. Keywords Antibiotics Á Lay understanding Á Ethnicity Á Immigrant Background and Conceptual Framework Antibiotic resistance is a serious and growing problem, caused by in part by overuse and misuse of antibiotics [1, 2]. There is considerable evidence of sub-optimal use of antibiotics in the community. This includes prescribing and use for inappropriate conditions, and use of inadequate treatment courses and sub-therapeutic doses [3–5]. All of these are likely to contribute to the growth and spread of antibiotic resistance. Although oral antibiotics cannot be purchased without a prescription from a healthcare professional in New Zea- land, patients’ understandings of antibiotics, and the decisions they make based on these understandings, are important. They can impact on prescription rates. Studies suggest prescribers are influenced by a desire to maintain or establish positive relationships with patients [6], and prescribe according to their perceptions of patient expec- tations [7]. Patient misunderstandings can also lead to sub- optimal use of antibiotics, such as using short courses and sub-therapeutic doses. Previous studies have found low levels of understanding and common misconceptions about antibiotics amongst lay people [8–11]. These studies have largely focussed on general population samples, although Pechere compared results from different countries [12], and Eng et al. analysed their data by demographic variables such as ethnicity, education and income [8]. Mangione-Smith et al. found that Latino and Asian parents were more likely than others to think that antibiotics were necessary for their child’s cold symptoms [13]. We hypothesised that immigrant ethnic groups may differ from the general population, and that immigrants from dif- ferent countries may differ from each other, in their understandings and patterns of use of antibiotics, due to their culture and experience of other health systems. If this is the case, this may have significant implications for education and counselling about antibiotics. Generally focussed cam- paigns may not address the specific misunderstandings of specific ethnic groups. In this study we chose three different population groups in New Zealand and surveyed their understanding and use of antibiotics, in order to determine P. Norris (&) Á L. F. Ng Á V. Kershaw Á F. Hanna Á A. Wong Á M. Talekar Á J. Oh Á M. Azer Á L. Cheong School of Pharmacy, University of Otago, Box 913, Dunedin, New Zealand e-mail: pauline.norris@otago.ac.nz 123 J Immigrant Minority Health (2010) 12:107–112 DOI 10.1007/s10903-008-9224-5