antibiotics Article Antibiotics Use and Its Knowledge in the Community: A Mobile Phone Survey during the COVID-19 Pandemic in Bangladesh Zubair Akhtar 1, * , Syeda Mah-E-Muneer 1 , Md. Mahbubur Rashid 1 , Md. Shakil Ahmed 1 , Md. Ariful Islam 1 , Sukanta Chowdhury 1 , Zobaid Khan 2 , Md. Zakiul Hassan 1,3 , Khaleda Islam 2 , Shahana Parveen 1 , Nitish Debnath 2 , Mahmudur Rahman 1,4 and Fahmida Chowdhury 1   Citation: Akhtar, Z.; Mah-E-Muneer, S.; Rashid, M.M.; Ahmed, M.S.; Islam, M.A.; Chowdhury, S.; Khan, Z.; Hassan, M.Z.; Islam, K.; Parveen, S.; et al. Antibiotics Use and Its Knowledge in the Community: A Mobile Phone Survey during the COVID-19 Pandemic in Bangladesh. Antibiotics 2021, 10, 1052. https:// doi.org/10.3390/antibiotics10091052 Academic Editor: Seok Hoon Jeong Received: 5 August 2021 Accepted: 27 August 2021 Published: 29 August 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; mahe@icddrb.org (S.M.-E.-M.); mahbubur.rashid@icddrb.org (M.M.R.); shakil.statru@gmail.com (M.S.A.); arif@icddrb.org (M.A.I.); sukanta@icddrb.org (S.C.); zhassan@icddrb.org (M.Z.H.); shahana@icddrb.org (S.P.); mrahman@globalhealthdev.org (M.R.); fahmida_chow@icddrb.org (F.C.) 2 Fleming Fund Country Grant to Bangladesh, DAI Global, LLC, House 3, First Floor, Road 23B, Gulshan 1, Dhaka 1212, Bangladesh; Zobaid_Khan@dai.com (Z.K.); Khaleda_Islam@dai.com (K.I.); Nitish_Debnath@dai.com (N.D.) 3 Nuffield Department of Medicine, University of Oxford, Oxford OX1 2JD, UK 4 Global Health Development, EMPHNET, 69 Mohakhali, Dhaka 1212, Bangladesh * Correspondence: zakhtar@icddrb.org Abstract: The general population has been excessively using antibiotics during the COVID-19 pandemic. Therefore, the use of antibiotics for any reported illnesses in the preceding four weeks and knowledge of antibiotics among the general population in the community were assessed for possible interventions. A mobile phone survey among a general population across eight administrative divisions of Bangladesh was conducted during January–March 2021. Reported illness episodes irrespective of COVID-19 in the preceding four weeks of the interview, use of antibiotics for the illnesses, and knowledge on antibiotics among the general population were recorded. Descriptive analyses were performed. We randomly interviewed 1854 participants, with a mean age of 28.5 years (range: 18–75 years); 60.6% were male. Among all participants, 86.3% (95% CI: 84.7–87.8) heard names of antibiotics, but only 12.1% reported unspecified harmful effects, and 3.5% reported antimicrobial resistance when antibiotics were taken without a physician’s prescription. Among 257 (13.9%) participants, who consumed medicines for their recent illness episode, 32.7% (95% CI: 27.2–38.6) reported using antibiotics. Of those who could recall the names of antibiotics prescribed (n = 36), the most frequently used was azithromycin (22.2%) followed by cefixime (11.1%) and ciprofloxacin (5.6%). Our findings show an increased antibiotic use for illnesses reported in the preceding four weeks and an elevated knowledge at the community level during the COVID-19 pandemic compared with the pre-pandemic period. Keywords: antibiotic resistance; COVID-19; pandemic; antibiotic awareness; antibiotic use 1. Introduction Modern healthcare is predominantly reliant on antibiotic treatment [1], but there has been a phenomenal and imprudent use of antibiotics leading to the advent of resistant strains of bacteria [2,3]. To address the antimicrobial resistance (AMR) as a whole, with more emphasis on antibiotic resistance, the World Health Organization (WHO) initiated a range of AMR-related activities, including the development of the Global Action Plan on Antimicrobial Resistance (GAP-AMR) by the 68th World Health Assembly in May 2015 [4]. Published literatures exhibit a high proportion of inappropriate use of antimicrobials, Antibiotics 2021, 10, 1052. https://doi.org/10.3390/antibiotics10091052 https://www.mdpi.com/journal/antibiotics