Abstract
Background: Many Thai people have misconceptions about antibiotics, such as an understanding that antibiotics are an anti-inflammatory drug. It has led to the misconception that the use of this drug will make existing disease heals faster because the drug is going to treat or cure inflammation. Many people do not know that bacteria can develop itself to resist antibiotics, therefore, they misunderstand that antibiotics can relieve pain, reduce fever which can lead to misuse of antibiotics. Drug resistance related knowledge and antibiotic misuse affect the development of drug-resistant strains. There are more than 38,000 deaths each year in Thailand which cost economical loss which accounted for 0.6% of gross domestic product.

Objectives: The purpose of this study was to assess drug resistance related knowledge, attitude toward drug resistance prevention, and drug resistance preventive behaviors among Thai people.

Materials and Methods: An online cross-sectional survey was conducted among 1123 Thai people who could access the internet. Drug resistance related knowledge, attitude, and behavior toward drug resistance prevention was assessed. Differences between outcomes and sociodemographic were analyzed through independent t-test, ANOVA.A generalized linear model was calculated to determine the predictive variables of preventive behaviors.

Results: Participants revealed moderate knowledge about drug resistance, correctly answering 9.86 (SD = 1.65) questions in a total of 15 and favorable attitudes toward preventive behaviors (M = 24.78, SD = 3.25). Participants reported on average 45.92 (SD = 7.25) of 12 behaviors in terms of always engaging in prevention, which was considered to be moderate. Females presented a higher level of knowledge, more positive attitude, and engaged in more preventive behaviors than males. Age, educational attainment, level of income, and knowledge about drug resistance had a negative correlation with preventive behavior toward drug resistance (r = –0.109**, r = –0.081**, r = –0.197**, and –0.111**, P< 0.01). Having a positive attitude toward preventive behavior of drug resistance predicted the adoption of those preventive behaviors (Exp (β) = 0.83, 95% CI: 0.046–0.325, P < 0.01).

Conclusion: Participants had a moderate level of knowledge on drug resistance, favorable attitude toward drug resistance prevention, and moderate level of preventive behaviors. Participants who had a busy lifestyle were more likely to compromise preventive behavior toward drug resistance, mostly in the 30–50 age group, even though their level of attitude toward prevention was at a good level. From the study, it is clear that prioritizing public knowledge on drug resistance is strongly and urgently advised to heighten attitudes toward drug resistance prevention to improve drug preventive behavior. More importantly, long-term systematic interventions and solutions should be considered, such as integrating, improving, and stressing the education on the issue of drug resistance.

Key words: Drug Resistance; Preventive Behavior; Anti-drug Resistance Behavior