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Many healthcare students lack knowledge that antibiotics do not speed recovery from colds and fluHealthcare students often lack clear knowledge on antibiotics and viruses

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Key Takeaway
Interpret these knowledge gaps as a target for educational interventions to reduce inappropriate antibiotic use for colds and flu.

This meta-analysis pooled data from 131 studies across 43 countries to assess healthcare students' knowledge of antibiotic use and resistance. The primary outcome was correct knowledge that antibiotics are effective against bacterial infections, which was high at 88.7% (95% CI: 87.0-90.5). However, knowledge that antibiotics are ineffective against viruses was lower at 70.0% (95% CI: 65.6-74.4).

More concerning, only 57.9% (95% CI: 51.5-64.3) knew that antibiotics are ineffective against colds and flu, and just 51.5% (95% CI: 41.6-61.4) knew that antibiotics do not speed up recovery from these illnesses. Regional variation was notable: in South Asia, only 41.3% (95% CI: 33.5-49.1) knew antibiotics do not speed recovery, compared to 98.0% (85% CI: 94.5-99.3) in North America.

The review did not report limitations, funding, or conflicts of interest. It measures knowledge levels, not clinical outcomes or patient behavior. These findings underscore the need for targeted educational interventions to address persistent misconceptions about antibiotic use for viral respiratory infections, which could contribute to antimicrobial resistance.

How this fits prior evidence

This meta-analysis extends prior coverage on antimicrobial resistance by quantifying knowledge gaps among healthcare students, a group that will influence future prescribing. It complements the finding that antibiotic prophylaxis in children with VUR increases resistance, and reinforces the call to maintain gut microbiome integrity as part of stewardship. The regional disparities align with the need for context-specific stewardship interventions, as seen in the Chinese NICU protocol.

When a patient comes down with a nasty cold or the flu, they often turn to their healthcare providers for answers. However, a large review of 131 studies across 43 countries shows that even those training to be medical professionals may not have a clear understanding of how antibiotics work. While many students knew that antibiotics treat bacterial infections, far fewer were certain about what these drugs can and cannot do when it comes to viruses.

Specifically, only about 58% of the surveyed healthcare students correctly understood that antibiotics are ineffective against colds and flu. Even more concerning is the gap in knowing whether these drugs actually speed up recovery from viral illnesses. While nearly 98% of students in North America knew antibiotics do not speed up recovery from colds or flu, that number dropped significantly to about 41% in South Asia.

This lack of clear knowledge is a concern because using antibiotics when they are not needed can lead to drug resistance. This makes it harder for doctors to treat serious bacterial infections later on. Because this study measured what students knew rather than how patients actually behave, we cannot say for certain how often these misunderstandings happen in real clinics.

What this means for you:
Many healthcare students lack clear knowledge about why antibiotics do not work against common colds and flu.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
AIMS: We synthesized and analysed existing evidence on healthcare students' knowledge of antibiotic use and resistance to provide pooled global and regional estimates. METHODS: The PubMed®, Embase® and CINAHL databases were searched for studies published between January 2015 and October 2025 that reported the knowledge of antibiotic use and resistance among healthcare students. Pooled estimates and 95% confidence interval (CI) of correct knowledge were determined using random-effects meta-analysis. RESULTS: Of the 8623 articles identified, 131 studies with data from 43 countries met the inclusion criteria. Most healthcare students correctly understood that antibiotics are effective against bacterial infections (88.7%, 95% CI: 87.0-90.5) but ineffective against viruses (70.0%, 95% CI: 65.6-74.4). However, only 57.9% (95% CI: 51.5-64.3) knew that antibiotics are ineffective against colds and flu, while just over half (51.5%, 95% CI: 41.6-61.4) of the students correctly knew that antibiotics do not speed up recovery from common colds and flu. Significant regional differences were observed in the understanding that antibiotics do not speed up recovery from common colds and flu, ranging from 41.3% (95% CI: 33.5-49.1) in South Asia to 98.0% (85% CI: 94.5-99.3) in North America. CONCLUSIONS: Although our findings indicate a substantial level of antibiotic knowledge across many of the evaluated outcomes, there are significant knowledge gaps in understanding of the ineffectiveness of antibiotics against the common cold and flu. These knowledge gaps have important implications for the rational use of antibiotics and the prevention of resistance.
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