Antimicrobial resistance : summary.
Date: 2023-01-26
Institutions: Directorate-General for Health and Food Safety
Subjects: antibiotic, antimicrobial resistance, consumer behaviour, consumer information, health risk, infectious disease, medicinal product, opinion poll, public health, report, sample survey

Special Eurobarometer 522 

Antimicrobial Resistance 

Summary 

Fieldwork: February-March 2022 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

Survey conducted by Kantar at the request of the European Commission, 
Directorate-General for Health and Food Safety - Public Health (DG SANTE) 

Survey co-ordinated by the European Commission, 
Directorate-General for Communication (DG COMM “Media monitoring and Eurobarometer" Unit) 

Special  Eurobarometer 522 

“Antimicrobial Resistance” 

EN 

EW-09-22-370-EN-N 

978-92-76-55054-9 

doi: 10.2875/733464 

Project title 

Language version 

Catalogue number 

ISBN 

© European Union, 2022  

https://www.europa.eu/eurobarometer 

Photo credit: Getty Images 

Special Eurobarometer 522 
February - March 2022 

TABLE OF CONTENTS 

INTRODUCTION 

I. 

USE OF ANTIBIOTICS 

II.  KNOWLEDGE OF ANTIBIOTICS 

III. 

INFORMATION ABOUT THE CORRECT USE OF ANTIBIOTICS 

IV.  POLICY RESPONSE 

V.  USE OF ANTIBIOTICS IN AGRICULTURE AND THE ENVIRONMENT 

VI. 

IMPACT OF THE COVID-19 PANDEMIC ON USAGE, NEED AND ACCESS TO ANTIBIOTICS 

CONCLUSION 

TECHNICAL SPECIFICATIONS 

4 

7 

11 

16 

22 

24 

27 

29 

 
 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

INTRODUCTION 

Antimicrobial  resistance  (AMR)  is  the  ability  of  micro-organisms 
(such  as  bacteria)  to  become  increasingly  resistant  to  an 
antimicrobial  to  which  they  were  previously  susceptible  –  when 
germs  like  bacteria  and  fungi  defeat  the  drugs  designed  to  kill 
them.  Although  AMR  is  a  naturally  occurring  process,  it  has 
increasingly  become  a  problem  and  threat  to  public  health  in 
Europe and other parts of the world.  One of the main drivers of 
AMR is the wrong use of antibiotics – such as for treating viruses 
or when not taken for the full course of treatment. Thus, a medical 
prescription  based  on  a  test  to  prove  bacterial  infection  should 
always be the norm to minimise wrong use and help preserve the 
efficacy of antibiotics for generations to come. 

AMR has a direct impact on human and animal health and results 
in substantial economic burden because of higher treatment costs 
and reduced productivity caused by sickness. It is estimated that 
AMR is responsible for 4.95 million deaths globally in 20191 and 
costs more than 1.5 billion euros each year to EU health systems 
in terms of healthcare costs and productivity losses2.  

Tackling  AMR  is  a  priority  for  the  European  Commission.  The 
Commission set out measures to address antimicrobial resistance 
through the European One Health action plan of June 20173, which 
follows the previous action plan adopted in 20114. The action plan 
covers over 70 actions involving nine policy areas espousing a One 
Health approach: including human and animal health, agriculture, 
environment and research. It is built on three pillars:  

  Making the EU a best practice region;  

  Boosting research, development and innovation;  

  Shaping the global agenda.  

In  June  2017,  the  Commission  adopted  the  first  deliverable:  EU 
guidelines  on  the  prudent  use  of  antimicrobials  in  human 
medicine5. These guidelines aim to reduce inappropriate use and 
promote prudent use of antimicrobials in people, targeting those 
who are responsible for or play a role in antimicrobial prescription 
(e.g.  doctors,  nurses,  pharmacists  and  hospital  administrators). 
Similar  guidelines  for  the  prudent  use  of  antimicrobials  in 
veterinary medicine6  have  been in  place  since 2015.  In  addition, 
the  EU  Regulations  on  veterinary  medicinal  products7  and  on 
medicated  feed8,  adopted  in  20199  and  that  came  into  force  in 
January  2022,  lay  down  a  wide  range  of  concrete  measures  to 
fight  AMR  and  promote  a  more  prudent  and  responsible  use  of 
antimicrobials in animals in line with the One Health approach.  

Brief : 

AMR-Tackling-the-Burden-in-the-EU: 

1 The Lancet, Global burden of Global burden of bacterial antimicrobial resistance in 
2019: a systematic analysis, January 20, 2022 
2ECDC/OECD 
Policy 
https://www.oecd.org/health/health-systems/AMR-Tackling-the-Burden-in-the-EU-
OECD-ECDC-Briefing-Note-2019.pdf  
3 COM(2017)339 
4 
lex.europa.eu/LexUriServ/LexUriServ.do?uri=COM:2011:0748:FIN:EN:PDF 
5  EU  Guidelines  for  the  prudent  use  of  antimicrobials 
in  human  health 
C/2017/4326;  OJ  C  212,  1.7.2017,  p.  1–12  http://eur-lex.europa.eu/legal-
content/EN/TXT/?uri=uriserv:OJ.C_.2017.212.01.0001.01.ENG&toc=OJ:C:2017:212:TO
C  

COM(2011)748 

COM(2011)748 

http://eur-

the  hugely 
The  COVID-19  pandemic  has  demonstrated 
destabilising effect of a communicable disease on society in the 
absence  of  effective  medicines  or  vaccines  to  stop  the  spread. 
While  COVID-19  predominated  the  headlines,  the  fight  against 
AMR  remains  of  the  highest  importance  as  we  cannot  allow 
bacteria  or  microbes  to  become  completely  resistant  to  the 
available  antimicrobials.  The  possible  effects  of  COVID-19  on 
accelerating  AMR  are  also  of  concern,  notably  if  antimicrobials 
were not used prudently. 

The knowledge, attitudes and behaviour of the public are of vital 
importance  for  setting  up  effective  EU  policies  to  help  ensure 
prudent  use  of  antimicrobials.  With  this  in  mind,  the  European 
Commission has undertaken a series of surveys among citizens to 
monitor their levels of knowledge and usage of antibiotics. The first 
survey,  undertaken  for  the  Directorate-General  for  Health  and 
Consumers, was conducted in 200910. Three further surveys were 
then carried out in 201311, 201612, and 201813. The current survey 
thus  represents  the  fourth  in  the  series  and  tracks  progress  on 
public use of and  knowledge about antibiotics. More specifically, 
the survey covers:  

  The use of antibiotics among the general public: whether they 
have  taken  antibiotics  in  the  last  year;  how  these  were 
obtained; the reason for taking them; and whether a test was 
carried out to confirm a bacterial infection before antibiotics 
were taken.  

  The levels of public knowledge about how antibiotics work and 

the risks associated with their unnecessary use. 

  Whether  citizens  have  received  enough  information  on  the 
need to curtail unnecessary antibiotic use and the impact this 
information has had on behaviour; and their interest in finding 
out more about antibiotics, along with perceptions of the most 
trustworthy sources for getting the information.  

  Views on the most appropriate policy response to AMR.  

  Attitudes  towards  the  use  of  antibiotics  on  sick  animals  and 
awareness of the ban on using antibiotics to stimulate growth 
in farm animals.  

  Consumption of antibiotics, and access and need for antibiotics 

in the context of the COVID-19 pandemic. 

6https://eur-lex.europa.eu/legal-
content/EN/TXT/?uri=CELEX%3A52015XC0911%2801%29 
7  Regulation  (EU)  2019/6  of  the  European  Parliament  and  of  the  Council  of  11 
December 2018 on veterinary medicinal products and repealing Directive 2001/82/EC 
(OJ L 4, 7.1.2019, p. 43) 
8  Regulation  (EU)  2019/4  of  the  European  Parliament  and  of  the  Council  of  11 
December 2018 on the manufacture, placing on the market and use  of medicated 
feed, amending Regulation (EC) No 183/2005 of the European Parliament and of the 
Council and repealing Council Directive 90/167/EEC (OJ L 4, 7.1.2019, p. 1) 
9 https://ec.europa.eu/food/animals/animal-health/vet-meds-med-feed_en 
10 http://ec.europa.eu/public_opinion/archives/ebs/ebs_338_en.pdf 
11 http://ec.europa.eu/health/antimicrobial_resistance/docs/ebs407_en.pdf 
12 http://ec.europa.eu/public_opinion/archives/ebs_445_en.pdf  
13 https://europa.eu/eurobarometer/surveys/detail/2190 

4 

 
 
 
 
Special Eurobarometer 522 
February - March 2022 

METHODOLOGY 

This survey was carried out by the Kantar Public Brussels network 
in the 27 EU Member States between 21 February and 21 March 
2022.  In  total,  26,511  respondents  from  different  social  and 
demographic  groups  were  interviewed  face-to-face  at  home  in 
their  mother  tongue  on  behalf  of  the  European  Commission, 
Directorate-General for Health and Food Safety.  

The methodology used is that of Eurobarometer surveys as carried 
out  for  the  Directorate-General  for  Communication  (“Media 
monitoring  and  Eurobarometer  Unit”).  However,  in  order  to  run 
fieldwork  during  the  COVID-19  pandemic,  it  was  necessary  to 
change the methodology (total or partial online interviews) in some 
Member States. A technical note on the way the interviews were 
conducted by the institutes within the Kantar network is annexed 
to this report. The interview methods and confidence intervals are 
also included. 14. 

Note: In this report, Member States are referred to by their official 
abbreviation, as listed below: 

*  Cyprus  as  a  whole  is  one  of  the  27  European  Union  Member 
States. However, the “acquis communautaire” has been suspended 
in the part of the country which is not controlled by the government 
of the Republic of Cyprus. For practical reasons, only the interviews 
carried out in the part of the country controlled by the government 
of the Republic of Cyprus are included in the “CY” category and in 
the EU27 average. 

We would like to thank all respondents in Europe who took 
the time to take part in this survey. 

Without their active participation, this survey would not 
have been possible. 

Belgium 
Bulgaria 
Czechia 
Denmark  
Germany 
Estonia 
Ireland 
Greece  
Spain 
France 
Croatia 
Italy 
Republic of 
Cyprus* 
Latvia 

Lithuania  
Luxembourg  
Hungary 

BE 
BG 
CZ 
DK  Malta 
DE 
EE 
IE 
EL 
ES 
FR 
HR 
IT 
CY* 

Netherlands 
Austria 
Poland 
Portugal  
Romania 
Slovenia 
Slovakia 
Finland 
Sweden 

LV 

LT 
LU 
HU 
MT 
NL 
AT 
PL 
PT 
RO 
SI 
SK 
FI 
SE 

European Union - weighted average for the 27 
Member States 

EU27 

14  The results tables are included in the annex. It should be noted that the total of 
the percentages in the tables of this report may exceed 100% when the respondent 
has the possibility of giving several answers to the question.  

5 

 
 
 
 
 
 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

KEY FINDINGS 

Less Europeans report having taken antibiotics in the last 
year than in the 2018 survey, which is also the lowest 
recorded level since 2009 

There has been a small improvement in Europeans’ 
knowledge of antibiotics since 2018 but more awareness 
is needed 

  The  majority  of  respondents  (72%)  still  lack  some  essential 
knowledge about antibiotics, with only about three in ten (28%) 
of  respondents  giving  the  correct  answer  to  all  of  the  four 
knowledge questions asked about antibiotics, while the overall 
European  average  number  of  correct  answers  is  2.79  out  of 
415 – a small increase (+0.06) compared to 2018.  

  The highest average number of correct answers is reported in 
Finland (3.33), and the lowest average in Romania (2.14). Since 
2018,  24  Member  States  show  the  same  results  or 
improvement in the average number of correct answers, with 
the most notable shifts in Portugal (2.82, +0.41), Croatia (2.89,  
+0.34)  and  Czechia  (3.03,  +0.33).  Only  three Member States 
show a small decline:  Romania (2.14, -0.16), Germany (2.76,  
-0.12), and Cyprus (2.52, -0.01).  

  Most  respondents  (82%)  are  aware  that  unnecessary  use  of 
antibiotics  makes  them  become  ineffective,  and  a  similar 
proportion  (85%)  know  that  one  should  only  stop  taking 
antibiotics after taking all of the prescribed dose as directed.  

  Around  two  thirds  of  respondents  (67%)  know  that  taking 
antibiotics often leads to side effects, such as diarrhoea and 
that antibiotics are not effective against colds (62%).  

  Half (50%) of respondents know that antibiotics are ineffective 
against  viruses.  This  represents  a  significant  increase  from 
2018 when 43% were aware of this but it also shows that half 
of Europeans need extra awareness on this essential fact. 

  Around  a  quarter  (23%)  of  respondents  say  that  they  have 
taken antibiotics in oral form at any time in the last 12 months. 
This is a substantial decrease (-9 percentage points) compared 
to that reported in the last survey in 2018 (32%) and is the 
lowest  recorded  level  since  the  first  AMR  Eurobarometer  of 
2009. 

  While  they  survey  does  not  explore  the  underlying  reasons 
behind  this  drop,  one  could  surmise  that  the  COVID-19 
pandemic may have been a major influencing factor. 

  The proportion of respondents who reported taking antibiotics 
varies by Member State: it is the highest in Malta (42%) and 
the lowest in Sweden and Germany (both 15%), Poland (16%) 
and the Netherlands and Denmark (both 18%).  

  Since 2018, the proportion of respondents who say they have 
taken antibiotics in the last year has decreased in all but two 
Member States.  
  The 

(27%,  
-20), Ireland (24%, -16), Portugal (19%, -13) and Cyprus 
(27%, -13), and Hungary (21%, -12) and Spain (30%, -12). 
  It  remained  the  same  in  Malta  (42%),  and  increased 

largest  decreases  are  seen 

Italy 

in 

slightly in Luxembourg (36%, +2). 

  People who say they have taken antibiotics are more likely to 
have left education at an earlier age (15 or under) and have 
difficulties paying household bills. They are also more likely to 
say that they received information about the unnecessary use 
of antibiotics and that this information has changed their views 
on the use of antibiotics. Other groups somewhat more likely 
to have taken antibiotics include women, and those who are 
not working like the unemployed, students, or retirees.  

  While the vast majority (92%) of respondents obtained their 
last course of antibiotics from a healthcare professional, either 
via  a  medical  prescription  (74%)  or  directly  from  a  medical 
practitioner  (18%),  around  8%  of  antibiotics  were  taken 
without a prescription – broadly similar to 2018.  

  Respondents  are  most  likely  to  cite  urinary  tract  infection 
(15%), a sore throat (13%), bronchitis (12%), a cold (11%), flu 
(10%),  and  fever  (10%)  as  reasons  for  taking  antibiotics. 
Another  9%  reply  they  have  taken  antibiotics  for  COVID-19. 
Overall, there is still a very large proportion of Europeans that 
cite  reasons  for  having  taken  antibiotics  that  are  either 
unjustified (i.e. viral infections or symptoms only such as fever) 
or at least questionable (like pneumonia or bronchitis) as those 
can be either viral or bacterial, necessitating a test to confirm 
the exact cause. 

  In addition, over half of respondents (53%) say that they did 
not have a test to find out the cause of their illness, before or 
at the same time as starting the antibiotics.  

  Close to eight in ten (79%) would like further information on 

antibiotics. 

15  Here  and  further  the  arithmetic  average  of  correct  answers  for  the  EU  and  per 
Member State is used 

6 

 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

I. USE OF ANTIBIOTICS  

Nearly a quarter of Europeans have taken antibiotics in the last 
year – representing a large decrease from the past survey and 
the lowest recorded level since 2009 

Respondents were first asked whether they had taken antibiotics 
in an oral form at any time in the last 12 months16. 

  Around  one  in  four  respondents  (23%)  say  that  they  have 
taken  antibiotics  orally  (such  as  tablets,  powder  or  syrup) 
during  the  last  year.  This  represents  a  large  decrease  (-9 
percentage  points)  compared  to  that  reported  in  the  2018 
survey (32%), and the lowest recorded level since 2009 (40%,  
-17 percentage points since 2009). 

A national analysis reveals that across all Member States less 
than half of the respondents say that they took antibiotics. In only 
three Member States, a third or more  respondents say that they 
took  antibiotics:  Malta  (42%),  Luxembourg  (36%),  and  Bulgaria 
(33%). In seven Member States, less than one in five say that they 
took antibiotics. Respondents are the least likely to do so in Sweden 
and Germany (both 15%), Poland (16%), and the Netherlands and 
Denmark (both 18%).  

Comparing  the  results  with  those  from  the  2018  survey,  the 
proportion of respondents who say that they took antibiotics in the 

last year decreased in all Member States, except in Luxembourg 
(36%,  +2),  while  they  remained  the  same  in  Malta  (42%).  The 
largest decreases occurred in Italy (27%, -20), Ireland (24%, -16), 
Portugal  (19%,  -13)  and  Cyprus  (27%,  -13), and  Hungary  (21%,  
-12) and Spain (30%, -12).  

In 14 out of 27 Member States, more than three quarters of 
respondents say they have not taken any antibiotics orally such 
as tablets, powder or syrup in the last 12 months 

16 QC1. Have you taken any antibiotics orally such as tablets, powder or syrup in the 
last 12 months? (ONE ANSWER ONLY): Yes; No; Don’t know. 

7 

 
 
 
 
Special Eurobarometer 522 
February - March 2022 

The  vast  majority  of  Europeans  (92%)  obtained  their  last 
course of antibiotics through a healthcare professional – either 
via  a  medical  prescription  or  directly  from  a  medical 
practitioner 

Tackling  antimicrobial  resistance  (AMR)  necessitates  improving 
prescription  practices  and  limiting  direct  access  to  antimicrobial 
medicines  so  that  they  are  only  available  through  prescriptions 
and only  when  needed,  in  addition  to  stopping  self-medication. 
It 
is  therefore  important  to  identify  how  Europeans  obtain 
antibiotics17. 
  The vast majority of respondents (92%, -1 percentage point) 
indicate having obtained their most recent course of antibiotics 
from  a  medical  practitioner.  This  figure  combines  the 
proportion who said that they obtained their antibiotics from a 
medical  prescription  (74%,  +2)  and  those  who  said  they 
received  the  antibiotics  directly  from  a  medical  practitioner 
(18%, -3).  

  A  small  minority  of  respondents  say  that  they  obtained 
antibiotics without a prescription from a pharmacy (4%, +1) or 
used 
(2%, 
-1).

left  over  from  a  previous  course 

those 

  In  addition,  2%  say  that  they  obtained  antibiotics  without  a 

prescription from elsewhere (+1). 

At the national level, at least eight in ten respondents in each EU 
Member  State  say  that  they  obtained  their  antibiotics  from  a 
medical practitioner. The highest proportions are found in Czechia 
(98%),  Poland  (97%),  and  Denmark  (96%),  while  the  lowest  are 
found  in  Romania  (80%),  Austria  and  Belgium  (both  84%),  and 
Hungary and Bulgaria (both 87%). 

17 QC2. How did you obtain the last course of antibiotics that you used? (ONE ANSWER 
ONLY): From a medical prescription; Administered by a medical practitioner; You had 
some left over from a previous course; Without prescription from a pharmacy; Without 
a  prescription  from  elsewhere;  Don’t  remember  (SPONTANEOUS),  Don’t  know. 
The  results  for  the  answers  “From  a  medical  prescription”  and  “Administered  by  a 

medical practitioner” are combined into a category “Total from a medical practitioner”; 
the results for the answers “You had some left over from a previous course”, “Without 
prescription  from  a  pharmacy”  and  “Without  prescription  from  elsewhere”  are 
combined into a category “Total not from a medical practitioner”  

8 

Special Eurobarometer 522 
February - March 2022 

Europeans  are  most  likely  to  cite  a  urinary  tract  infection,  a 
sore throat, bronchitis, a cold, flu, and a fever as reasons for 
taking antibiotics  

One in seven respondents (14%) say that they took antibiotics for 
reasons that were not specified on the list of options presented to 
them, the same proportion as two years ago.  

  Among  the 

illnesses  and  symptoms  shown  to  them, 
respondents  are  most  likely  to  cite  a  urinary  tract  infection 
(15%,  +3  percentage  points),  a  sore  throat  (13%,  -1)  and 
bronchitis (12%, -4) as reasons for taking their last course of 
antibiotics.  

  About  close  to  one  third  (30%)  of  respondents  still  took 
antibiotics for cold (11%, +3) or a flu (10%, -2) and another 
9% also report taking antibiotics for Covid-19, diseases which 
are  generally  caused  by  viruses,  not  bacteria,  and  for  which 
antibiotics are ineffective unless there is a secondary bacterial 
infection. 

9 

QC3 What was the reason for last taking the antibiotics that you used?  (MULTIPLE ANSWERS POSSIBLE)1513121110109988842141050471912141681211908745214614844190102030405060February/March 2022September 2018Urinary tract infectionSore throatBronchitis (inflammation and swelling of the bronchi, the airways that carry airflow from the trachea into the lungs)ColdFluFeverSkin or wound infectionCOVID-19Rhinopharyngitis (inflammation of the mucous membrane of the nose and pharynx)CoughHeadachePneumonia (an infection causing an inflammation of one or both lungs)DiarrheaOther (SPONTANEOUS)Refusal (SPONTANEOUS)Don't knowSymptom onlyIllness onlyCold/FluJust above half of Europeans (53%) say they did not have a 
test to find out the cause of their illness, before or at the same 
time as starting the antibiotics 

  Less than half (46%) say they had a test to find out the cause 
of  their  illness,  before  or  at  the  same  time  as  starting  the 
antibiotics, a slight increase (+5 percentage points) from two 
years ago, whereas a narrow majority (53%, -3) indicate they 
had not.  

At  national  level,  substantial  variation  can  be  found.  In  16 
Member at least half of the respondents say they had a test, with 
more than two thirds (67%) indicating this in Czechia, close to two 
thirds  (65%)  in  Croatia,  and  63%  in  Denmark  and  Estonia. 

Respondents  are  least  likely  to  indicate  this  in  Poland  (29%), 
Romania (31%), and the Netherlands and France (both 39%).  

10 

 
 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

II. KNOWLEDGE OF ANTIBIOTICS

Half  of  Europeans  correctly  think  that  antibiotics  are 
ineffective against viruses: 

  Across the EU, half (50%) of respondents correctly say that the 

statement that antibiotics kill viruses is false18. 

  Nearly two out of five (39%) incorrectly think that antibiotics 
do kill viruses, and more than one in ten (11%) indicate they 
do not know.  

Since  2018,  there  has  been  a  marked  increase  (+7  percentage 
points) in the proportion of respondents correctly saying that it is 
false  that  antibiotics  kill  viruses,  and  a  commensurate  decrease 
among those who incorrectly think that this statement is true (-9). 
A slightly higher proportion (+2) are unable to express an opinion.  

An  analysis  at  the  national  level  shows  some  interesting 
variations among Member States. In 11 Member States, a majority 
of respondents know that antibiotics do not kill viruses,  with two 
thirds or more saying this in Sweden (77%), Luxembourg (73%), 
the Netherlands (68%), and Ireland (66%).  

18 QC5.1For each of the following statements, please tell whether you think it is true 
or false: Antibiotics kill viruses (ONE ANSWER ONLY): True; False; Don’t know (Correct 
answer – False) 

11 

Special Eurobarometer 522 
February - March 2022 

A  majority  of  Europeans,  close  to  two  thirds,  correctly  think 
that antibiotics are ineffective against colds 

  A majority (62%) of respondents across the EU correctly say 
that  the  statement  that  antibiotics  are  effective  at  treating 
colds is false.19  

  Three  in  ten  (30%)  answered  incorrectly  that  it  is  true  that 
antibiotics  are  effective  against  colds,  with  a  small  minority 
(8%) indicating that they do not know.  

Between 2018 and 2022, there has been a slight decrease in the 
proportion of respondents who are aware that antibiotics are not 
effective against colds (-4 percentage points), an increase in the 
proportion giving the incorrect answer (+2), as well as among those 
who indicate that they do not know (+2). 

The  large  majority  of  Europeans  are  aware  that  using 
antibiotics unnecessarily makes them become ineffective 

  More than four in five respondents (82%) correctly answer that 
it  is  true  that  unnecessary  use  of  antibiotics  makes  them 
become ineffective.20  

  One in ten (10%) incorrectly say that this statement is false, 
with close to one in ten (8%) indicating that they don’t know. 

The results have not changed much compared to those that were 
reported in 2018. There has been a small but noticeable decrease 
in  the  proportion  of  respondents  who  correctly  think  that  using 
antibiotics  unnecessarily 
ineffectiveness  (-3 
percentage points), a slight increase among those who incorrectly 
say  that  this  is  false  (+1),  along  with  a  small  increase  in  the 
proportion who say they are unable to express an opinion (+2).  

leads  to  their 

19 QC5.2For each of the following statements, please tell whether you think it is true 
or false: Antibiotics are effective against colds (ONE ANSWER ONLY): True; False; Don’t 
know (Correct answer – False) 

20 QC5.3 For each of the following statements, please tell whether you think it is true 
or  false:  Unnecessary  use  of  antibiotics  makes  them  become  ineffective  (ONE 
ANSWER ONLY): True; False; Don’t know (Correct answer – True) 

12 

Special Eurobarometer 522 
February - March 2022 

Around  two  thirds  of  Europeans  know  that  taking  antibiotics 
often leads to side effects, such as diarrhoea 

  Just  over  two  thirds  of  respondents  (67%)  are  aware  that 
taking  antibiotics  often  leads  to  side  effects,  such  as 
diarrhoea.21  

  One in six (17%) incorrectly say that it is false that antibiotics 

often leads to side effects. 

  More uncertainty is found among respondents on whether this 
is  true  or  false,  with  one  in  seven  (16%)  unable  to  give  an 
answer, substantially more than for the previous questions.  

Findings  are  largely  similar  to  those  reported  in  2018.  The 
proportion  of  respondents  who  correctly  think  that  taking 
antibiotics  often  leads  to side effects  has  decreased  slightly  (-1 
percentage  point).  The  proportion  of  those  interviewed  who 
incorrectly say that this is false has stayed the same, with a very 
small  increase  among  those  who  indicate  that  they  don’t  know 
(+1). 

The  analysis  at  national  level  shows  relatively  little  variation 
among the different Member States. Across all Member States, a 
majority  of respondents  answer  this  question  correctly,  with  the 
highest proportions found in Poland (81%), Slovakia, Finland, and 
Estonia (79% all), and Austria (77%). Respondents are least likely 
to  say  that  taking antibiotics  often  leads  to  side  effects  include 
Romania  (57%),  France  (60%),  and  the  Netherlands  and  Ireland 
(63%).  In  23  Member  States,  one  in  ten  or  more  respondents 
indicate that they don’t know, with one in five or more saying this 
in Portugal (22%), and Cyprus, Germany and Spain (20% all).  

In 13 Member States the proportion of respondents who correctly 
say taking antibiotics often leads to side effects is true has stayed 
the  same  or  increased  since  2018.  The  most  notable  increases 
have taken place in Croatia (74%, +14 percentage points), Latvia 
(70%, +8), and Denmark (74%, +5), and Sweden (64%, +5). In the 
remaining  14  Member  States  the  proportion  giving  the  correct 
answer has decreased, with the largest decreases seen in Cyprus 
(75%, -9), Germany (67%, -7) and Lithuania (72%, -6).  

Compared to 2018, respondents are more likely to say they do not 
know in Cyprus (20%, +8), and Lithuania (18%, +6).  

21 QC5.4 For each of the following statements, please tell whether you think it is true 
or false: Taking antibiotics often has  side-effects such as diarrhoea (ONE ANSWER 
ONLY): True; False; Don’t know (Correct answer – True)  

13 

Special Eurobarometer 522 
February - March 2022 

This  section  collates  the  findings  for  each  of  the  four  individual 
statements  used 
respondents’  knowledge  about 
antibiotics.22  

test 

to 

  Across the EU, on average, only over a quarter of respondents 
(28%)  answered  all  four  questions  correctly,  with  the  same 
proportion  (28%)  giving  at  least  three  correct  answers,  and 
almost  all  respondents  (94%)  providing  at  least  one  correct 
answer23.  

  The  overall  average  number  of  correct  answers  is  2.79  out  

of 4.  

The results are broadly comparable to those reported in 2018. The 
overall average has increased from 2.73 to 2.79. 

A small increase can be noted in the proportion answering all four 
questions correctly (+3 percentage points), a slight decrease in the 
proportion giving at least three correct answers (-4), and a small 
decrease in the proportion who gave at least one correct answer  
(-1). 

The analysis at national level shows the highest average number 
of  correct  answers  in  Finland  (3.33),  Sweden  (3.28),  and 
Luxembourg (3.23), with the lowest average recorded in Romania 
(2.14), Cyprus (2.52), and Hungary (2.55).  

22 QC5R For each of the following statements, please tell whether you think it is true 
or false. 

23 QC5R For each of the following statements, please tell whether you think it is true 
or false. 

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Special Eurobarometer 522 
February - March 2022 

Most Europeans are aware that they should complete the full 
course of antibiotic treatment24 

  More  than  four  in  five  respondents  (85%)  correctly  say  that 
antibiotic  treatment  should  only  be  stopped  when  all  of  the 
antibiotics have been taken as directed.  

  Nevertheless,  around  one 

(13%) 
incorrectly think that they should stop taking antibiotics when 
they feel better.  

in  eight  respondents 

The  results  are  similar  to  findings  reported  in  2018.  A  slight 
increase (+1 percentage point) has been recorded in the proportion 
of  respondents  correctly  saying that  treatment  should  only  stop 
when all the antibiotics have been taken, but no decrease in the 
proportion  who  incorrectly  say  that  the  antibiotics  should  be 
stopped when they feel better25.  

24 QC6. When do you think you should stop taking antibiotics once you have begun a 
course  of  treatment?  (ONE  ANSWER  ONLY):  When  you  feel  better;  When  you  have 

taken all of the antibiotics as directed by your doctor; Other (SPONTANEOUS); Don't 
know 
25 The difference being due to a one percentage point decrease in the category ‘Other’.  

15 

 
 
 
 
  
 
 
Special Eurobarometer 522 
February - March 2022 

III.  INFORMATION ABOUT THE 

CORRECT USE OF ANTIBIOTICS 

Almost a quarter of Europeans remembers getting information 
about not taking antibiotics unnecessarily 26 

  A  large  majority  of  respondents  (77%)  do  not  remember 
taking  antibiotics 
information  about  not 

getting  any 
unnecessarily, for example for a cold.  

  Close  to  a  quarter  (23%)  of  respondents  say  that  they  do 

remember receiving such information. 

Between  2018  and  2022,  the  results  changed  significantly. 
Europeans  are  now  much  less  likely  (-10  percentage  points)  to 
remember having received information about not taking antibiotics 
unnecessarily. 

26 QC7. In the last 12 months, do you remember getting any information about not 
taking antibiotics unnecessarily, for example for a cold? (ONE ANSWER ONLY):  Yes; 
No; Don’t know 

16 

 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

Europeans  are  most  likely  to  have  obtained  the  information 
from  a  doctor,  followed  by  television  news  or  other 
programmes or a television advertisement27 

Close to half of respondents (45%) say they got information about 
not taking antibiotics unnecessarily from a doctor, an increase of 
four percentage points compared to 2018. Close to a quarter (23%,  
-5) indicate getting this information on the television news or other 
programmes.  Just  over  one  in  five  (22%,  -2)  say  they  got  this 
information  from  a  TV  advertisement.  Close  to  one  in  five 
respondents  (18%,  +4)  obtained  information  about  not  taking 
antibiotics  unnecessarily  from  a  pharmacist,  followed  by  the 
Internet  or  online  social  networks  (16%,  +1),  newspapers  (14%,  
-5), or a family member or friend (13%, +2).  

When  looking  at  professional  sources  overall,  in  addition  to 
mentions  of  a  doctor  (45%),  or  a  pharmacist  (18%),  a  smaller 
proportion (8%) mention another health professional (e.g. nurse or 
physiotherapist).  Combining  these  responses,28  we  note  that  a 
majority  of  respondents  (55%,  +7)  got  their  information  from  a 
professional or healthcare facility.  

27 QC8. Where did you get this information about not taking antibiotics unnecessarily? 
(MULTIPLE  ANSWERS  POSSIBLE):  From  a  doctor;  From  a  pharmacist;  From  another 
health professional (e.g. nurse or physio-therapist); From a family member or friend; 
From a TV advertisement; On the Internet or in online social networks; In a leaflet or 

on a poster; In a newspaper; On the TV news or other programmes; On the radio; Other 
(SPONTANEOUS); Don't know. 
28 The percentage was calculated based on participants who have chosen ANY of the 
answer  options:  “From  a  doctor”,  “From  a  pharmacist”  or  “From  another  health 
professional…”. 

17 

 
 
 
Special Eurobarometer 522 
February - March 2022 

Comparing  to  2018,  slightly  more  Europeans  say  that  the 
information  they  obtained  about  the  unnecessary  use  of 
antibiotics changed their views about using them.29 

  Around  three  in  ten  (34%)  respondents  who  said  they  had 
received information about not taking antibiotics unnecessarily 
say  that  the  information  changed  their  views  on  using 
antibiotics.  

  For  most  respondents  (66%),  the  information  did  not  affect 

their opinions on this matter.  

  Compared to findings reported in 2018, there has been a slight 
increase  in  the  proportion  of  respondents  saying  that  the 
information  changed  their  views  on  using  antibiotics  (+5 
percentage points).  

At the national level we observe significant variations regarding 
information affecting respondents’ views on antibiotic use.  

In  five  Member States  the  majority  of respondents  say  that  the 
obtained  information  changed  their  views  on  using  antibiotics: 
Cyprus (70%), Malta (64%), Slovakia (57%), Bulgaria (56%), and 
Luxembourg (55%).  

29 QC9. Did the information that you received change your views on using antibiotics? 
(ONE  ANSWER  ONLY):  You  will  always  consult  a  doctor  when  you  think  you  need 
antibiotics; You will no longer self-medicate with antibiotics; You will no longer take 
antibiotics  without  a  prescription  from  a  doctor;  You  will  no  longer  keep  left  over 

antibiotics for next time you are ill; You will give left-over antibiotics to your relatives 
or friends when they are ill; Other (SPONTANEOUS); None (SPONTANEOUS); Refusal 
(SPONTANEOUS); Don’t know. 

18 

 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

A majority of Europeans say from now on they plan to always 
consult a doctor in cases where antibiotics are needed30. 

  Around two thirds (63%) of respondents say that they now plan 
to  always  consult  a  doctor  in  situations  where  they  think 
antibiotics are needed, while close to two fifths (38%) say they 
will no longer take antibiotics without a doctor’s prescription.  

  Around one in four respondents (22%) say they will no longer 
self-medicate with antibiotics, and around the same proportion 
(21%) indicates they will no longer keep left-over antibiotics 
for use next time they are ill.  

  A  very  small  minority  (6%)  mention  the  inappropriate 
behaviour change – saying they will give left-over antibiotics 
to relatives or friends when they are ill.  

These  results  have  not  changed  much  compared  to  those  from 
2018. There are small decreases in the proportion of respondents 
who say: they will always consult a doctor (-2 percentage points); 
will no longer take antibiotics without a prescription (-1) and will 
no  longer  self-medicate  (-1).  A  slight  increase  is  noted  in  the 
proportion of those who will no longer keep left-over antibiotics for 
future use (+2). There has been a small increase in the proportion 
of respondents  saying  that  they  will  give  left-over  antibiotics  to 
relatives or friends when they are ill (+1).  

30Q10.  On  the  basis  of  the  information  you  received,  how  do  you  now  plan  to  use 
antibiotics? (MULTIPLE ANSWERS POSSIBLE): You will always consult a doctor when 
you think you need antibiotics; You will no longer self-medicate with antibiotics; You 
will no longer take antibiotics without a prescription from a doctor; You will no longer 

keep left over antibiotics for next time you are ill; You will give left-over antibiotics to 
ill;  Other  (SPONTANEOUS);  None 
your  relatives  or  friends  when  they  are 
(SPONTANEOUS); Do not wish to answer (SPONTANEOUS); Don’t know.  

19 

 
 
 
 
Special Eurobarometer 522 
February - March 2022 

antibiotics (+2). The proportion of respondents who say they don't 
want  to  receive  more  information  on  these  issues  decreased 
sharply (-10). 

A  large  majority  of  respondents  would  like  to  receive  more 
information on antibiotics31. 

  Close to eight in ten (79%) respondents say that they want to 

receive more information about antibiotics overall. 

  Close to a third (31%) of respondents say they would like more 
information  on  medical  conditions  for  which  antibiotics  are 
used, with the same proportion (31%) saying they would like 
information on links between the health of humans, animals 
and  the  environment,  and  similar  proportions  expressing  the 
wish to learn more about resistance to antibiotics (29%), and 
how to use antibiotics (28%). 

  Respondents  are  somewhat 

less 

likely  to  want  more 

information on the prescription of antibiotics (17%).  

  Over one in ten (11%) spontaneously say that they do not wish 

to receive more information on any of these subjects.  

The results have shifted noticeably compared to the results seen 
in  2018.  The  largest  increase  is  reported  in  the  proportion  of 
respondents  who  say  they  would  like  more  information  on  links 
between the health of humans, animals and the environment (+7 
percentage points), with comparable increases regarding medical 
conditions  for  which  antibiotics  are  used  (+5),  resistance  to 
antibiotics (+4); how to use antibiotics (+4); and the prescription of 

31 Q11 On which topics, if any, would you like to receive more information? (MULTIPLE 
ANSWERS  POSSIBLE):  Resistance  to  antibiotics;  How  to  use  antibiotics;  Medical 
used; 
conditions 

antibiotics 

which 

are 

for 

Prescription  of  antibiotics;  Links  between  the  health  of  humans,  animals  and  the 
environment; Other (SPONTANEOUS); None (SPONTANEOUS); I don’t want to receive 
more information on these issues (SPONTANEOUS); Don’t know. 

20 

 
 
 
 
Special Eurobarometer 522 
February - March 2022 

Europeans  are  much  more  likely  to  go  to  a  doctor  to  get 
trustworthy  information  on  antibiotics  than  any  other  source 
of information32. 

  Respondents are most likely to view medical professionals or 
healthcare  facilities  as  the  most  trustworthy  sources  of 
information  on  antibiotics.  Close  to  nine  in  ten  (86%) 
respondents mention doctors.  

  Two fifths (40%) mention pharmacies while close to one in five 
(19%)  mention  hospitals,  with  a  similar  proportion  (17%) 
mentioning official health-related websites, followed by nurses 
(13%), another healthcare facility (8%), family or friends (6%), 
and other health-related websites (5%).  

  Less than 5% mention television (4%), online social networks 
(3%), health-related personal blogs (2%), or radio (1%).  

The results from this survey are largely similar to those in 2018, 
with the exception of an official health-related website that was 
mentioned substantially more often (+4 percentage points), and a 
slight increase regarding another health care facility and another 
health-related  website  (both  +2).  A  small  decrease  is  registered 
regarding hospitals and pharmacies (both -2).  

32 QC12. Which of the following sources of information would you use in order to get 
trustworthy  information  on  antibiotics?  (MAX.  3  ANSWERS):  A  doctor;  A  nurse;  A 
pharmacy; A hospital; Another healthcare facility; Family or friends; An official health- 
related website (e.g. a website set up by the national government/ public health body/ 

European  Union);  A  health-related  personal  blog;  Another  health-related  website; 
radio;  Other 
Online  social  networks;  TV;  Newspapers  or  magazines;  The 
(SPONTANEOUS);  You  are  not  interested  in  finding  information  on  antibiotics 
(SPONTANEOUS); Don’t know. 

21 

 
 
Special Eurobarometer 522 
February - March 2022 

IV.  POLICY RESPONSE

Close to a third of Europeans think that action at a global level 
is  the  most  effective  way  to  tackle  resistance  to  antibiotics, 
while around  one in five believe action at a national level or 
individual or family level is best33 

  Just under a third of respondents (30%) think that action at a 
global level is the most effective way  to tackle resistance to 
antibiotics.  

  One in five respondents (21%) believe resistance to antibiotics 
can be most effectively dealt with at a national level, while the 
same  proportion  thinks  the  individual  or  family  level  is  best 
suited for this.  

  Just over one in ten respondents (11%) think action at an EU 
level is best, while 8% think action at the regional level is the 
most effective way to deal with resistance to antibiotics. 

  These results are broadly in line with those reported in 2018. 
There  has  been  a  small  increase  in  the  proportion  of 
respondents thinking that action at a global level is the most 
effective way of tackling AMR (+3 percentage points) as well 
as  a  small  increase  in  the  proportion  thinking  the  most 
effective way of tackling AMR is at a national level, at the EU 
level, and at the individual level or within the family (+2 all). A 
significantly smaller proportion of respondents (3%, -8) think 
action at all levels is needed.  

33  QC13.  At  what  level  do  you  believe  it  is  most  effective  to  tackle  resistance  to 
antibiotics? (ONE ANSWER ONLY): At individual level or within the family; At regional 

level;  At  national  level;  At  EU  level;  At  global  level;  Action  at  all  levels  is  needed 
(SPONTANEOUS); Don’t know. 

22 

 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

The highest proportions of respondents who think that actions to 
tackle resistance to antibiotics should be taken at EU level are seen 
in  the  Cyprus  (18%),  Austria  and  Malta  (both  16%),  and  Greece 
(15%). Respondents are least likely to think this way in Latvia (5%), 
Estonia and Finland (both 6%), and Portugal (7%). The proportion 
of respondents saying this has stayed the same or increased in 20 
Member States, most notably in Malta (16%, +10), Poland (15%,  
+7), Italy (13%, +7), and Hungary (10%, +6). 

The only EU Member States where more than one in ten say that 
action at the regional level is the most effective way to tackle 
this issue are Romania (12%), and Slovakia, Austria and Germany 
(11% all). No major changes are seen in this context compared to 
2018, with respondents equally or slightly more likely to mention 
the regional level in 22 Member States, and slightly less likely in 
five.  

Respondents are most likely to indicate that they don’t know in 
France (14%), Estonia (13%), and Latvia and Lithuania (both 9%). 
In all but four Member States, respondents are less likely to say 
that they don’t know, with the largest decreases registered in Malta 
(1%, -10), Bulgaria (7%, -9), and Estonia (13%,  -7), Poland (5%,  
-7), and Cyprus (5%, -7). 

There are 13 Member States where respondents are most likely to 
think that action at a global level is the most effective way of 
tackling  resistance  to  antibiotics.  In  only  one  Member  State, 
Sweden  (53%),  is  this  sentiment  shared  by  a  majority  of  the 
respondents, followed by Cyprus (43%), Luxembourg (42%), and 
the Netherlands (40%). Respondents are least likely to think this 
way  in  Poland  (9%),  Romania  and  Bulgaria  (both  14%),  and 
Hungary (17%). In 20 Member States, respondents are equally or 
more  likely  to  think  that  action  at  a  global  level  is  the  most 
effective  way  to  tackle  this  issue  compared  to  2018,  with  the 
largest  increases  seen  in  Cyprus  (+23),  Italy  (34%,  +13),  and 
Portugal  (32%,  +12).  Only  small  decreases  are  seen  in  the 
remaining seven Member States, chiefly: Denmark (37%, -6).  

In eight Member States, respondents are most likely to think that 
action at the national level is best suited for tackling resistance 
to  antibiotics,  chiefly:  Poland,  Greece,  and  Ireland  (35%  all), 
Romania  (31%),  and  Bulgaria  (29%).  The  lowest  proportions  are 
seen  in Slovenia  (12%),  Germany  (13%),  and  Cyprus  (15%).  The 
proportion  of  respondents  saying  this  has  stayed  the  same  or 
increased in 18 Member States, most notably in Denmark (26%,  
+12), Poland (35%, +9), and Bulgaria (29%, +7). The largest, albeit 
still limited, decrease is seen in Portugal (26%, -4). 

There are a further six Member States where respondents are most 
likely  to  say  that  action  at  the  individual  level  or  within  the 
family  is  optimal  for  this  purpose,  with  the  highest  proportions 
registered  in  Slovenia  (44%),  Latvia  (36%),  and  Croatia  (32%). 
Respondents  are  least  likely  to  think  this  way  in  Sweden  (10%), 
Denmark  (11%),  Italy  (12%),  and  Cyprus  (15%).  Twenty-one 
Member States saw the same or higher proportions of respondents 
saying this compared to 2018, with the largest increases seen in 
Bulgaria (25%, +12), Malta (27%, +10), Slovakia (23%, +10), and 
Portugal (17%, +8).

23 

 
 
 
Special Eurobarometer 522 
February - March 2022 

V.  USE OF ANTIBIOTICS IN 
AGRICULTURE AND THE 
ENVIRONMENT  

Close to two thirds of Europeans agree that sick animals have 
the right to be treated with antibiotics34 

Administering  antibiotics  to  sick  animals  is  an  integral  part  of 
veterinary  medicine  and  animal  welfare.  Resistant  bacteria  in 
animals  are  not  only  a  threat  to  animal  health  but  can  risk 
contaminating  humans,  for  example  through  direct  contact 
between  animals  and  humans  and  through  the  food  chain.  The 
interviewers explained to the respondents that they wanted to talk 
about  the  use  and  effects  of  antibiotics  in  farm  animals  (i.e. 
animals  used  for  consumption  –  meat,  dairy  products,  etc.). 
Respondents were then asked whether they agreed or disagreed 
with  the  use  of  antibiotics  in  sick  animals  if  this  is  the  most 
appropriate treatment35.  

  Close  to  two  thirds  of  respondents  (64%)  agree  that  sick 
animals have the right to be treated with antibiotics if this is 
the most appropriate treatment, with close to one in five (19%) 
saying they ‘totally agree’.  

  Close  to  a  third  of  respondents  (31%)  disagree  that  sick 
animals have the right to be treated, with just over one in ten 
(11%) saying they ‘totally disagree’. 

  Compared to the findings from the survey carried out in 2018, 
there  has  been  a  substantial  increase  in  the  proportion  of 
respondents who ‘agree’ that sick animals have the right to be 
treated with antibiotics (+8 percentage points), which is mostly 
attributable to an increase among those interviewed who ‘tend 
to  agree’  (+9).  Overall,  the  proportion  who  say  that  they 
‘disagree’ that sick animals have this right has decreased (-4). 
The proportion of those who indicate that they don’t know has 
decreased (5%, -4).  

34 Q14. To what extent do you agree  or disagree that sick farm animals should be 
treated  with  antibiotics  if  this  is  the  most  appropriate  treatment?  (ONE  ANSWER 
ONLY): Totally agree; Tend to agree; Tend to disagree; Totally disagree; Don’t know. 

24 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

Respondents  are  most  likely  to  disagree  with  the  proposed 
statement in Slovenia (41%), Germany (40%), Luxembourg (39%), 
and  Austria  (37%).  In  14  Member  States  more  than  one  in  ten 
respondents ‘totally disagree’ that sick animals have the right to 
be  treated  with  antibiotics,  most  notably  in  Cyprus  (21%), 
Luxembourg (17%), and Slovenia and Croatia (both 15%). 

Only in Estonia are more than one in ten respondents (11%) unable 
to express an opinion on whether sick animals have the right  to 
antibiotic treatment.  

At the national level, substantial variations can be noted.  

In all 27 Member States at least half of respondents agree that 
sick animals have the right to be treated with antibiotics. In nine 
Member  States,  more  than  seven  in  ten  think  this  way,  most 
notably  in  Ireland  (83%),  Portugal  (81%),  Finland  (78%)  and 
Belgium  (77%).  In  11  Member  States,  more  than  one  in  five 
respondents ‘totally agree’ that sick animals have the right to be 
treated with antibiotics.  

Comparing  the  results  at  the  national  level  with  those  from  the 
2018 survey, the proportion of respondents who agree that sick 
farm animals should be treated with antibiotics if this is the most 
suitable treatment has increased in all 27 Member States, most 
notably in Italy (61%, +22), Croatia (67%, +18), and Slovenia (56%,  
+15). In 19 Member States, those who ‘totally agree’ stayed the 
same or increased; chiefly: Greece (21%, +8), Lithuania (27%, +7), 
and Malta (30%, +6). 

25 

 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

Close to three in five Europeans are not aware of the EU ban 
on the use of antibiotics to stimulate growth in farm animals 

  The ban on the use of antibiotics to stimulate growth in farm 
animals in the EU is a major milestone of the EU’s efforts to 
curb  the  inappropriate  use  of  antimicrobials  in  agriculture, 
directly affecting the quality of animal health and the food we 
eat. Only around two fifths of respondents (42%) are aware 
that the use of antibiotics to stimulate growth in farm animals 
is banned in the EU, however, slightly more than in the previous 
wave (+4 percentage points). 

  A majority of respondents (57%) do not know that such a ban 

exists. 

  The findings are broadly in line with those reported in 2018. As 
mentioned  above,  there  has  been  a  slight  increase  in  the 
proportion saying that they know that the use of antibiotics to 
stimulate growth in farm animals is banned in the EU (+4), and 
a slight decrease among those who are not aware of this (-1), 
commensurate with a smaller proportion of those who indicate 
that they don’t know either way (-3).36  

At the national level, noticeable differences exist among different 
Member States.  

In  six  Member  States,  a  majority  of  respondents  say  they  know 
there is an EU ban on the use of antibiotics to stimulate growth in 
farm animals. They are most likely to say this in  Finland (58%), 
Italy  (57%),  and  Sweden  and  the  Netherlands  (both  56%). 
Respondents are least likely to be aware about this ban in Greece 
(27%), Portugal and Romania (both 30%), and Cyprus (33%).

Comparing the results at a national level with those from the 2018 
survey, the proportion of respondents who say they know this ban 
exists has stayed constant or increased in 24 Member States and 
decreased, slightly, in three. The largest increases were registered 
in  Sweden  (56%,  +19),  Slovakia  (54%,  +15),  and  Finland  (58%,  
+12). The declines took place in Portugal (30%, -3), Cyprus (33%,  
-2), and Belgium (43%, -1). 

36 QC15. Did you know that using antibiotics to stimulate growth in farm animals is 
banned within the EU? (ONE ANSWER ONLY): Yes; No; Don’t know. 

26 

 
 
 
 
 
 
Special Eurobarometer 522 
February - March 2022 

VI.  IMPACT OF THE COVID-19 
PANDEMIC ON USAGE, NEED AND 
ACCESS TO ANTIBIOTICS 

Among those who suffered from COVID-19, most did not take 
any antibiotics yet still a small minority (4%) took antibiotics 
without a prescription37 

  A  majority  of respondents  (62%)  indicated  that  they  did  not 
suffer from COVID-19, while 28% say they did not take any 
antibiotics. Of those who did, 6% say they did take antibiotics 
with  a  medical  prescription,  2%  say  they  had  antibiotics 
administrated by a medical practitioner. A further 2% that they 
took some antibiotics left from a previous course, 1% say they 
took  antibiotics  without  prescription  from  a  pharmacy  and 
another 1% without prescription from elsewhere. 

  Overall,  the  overwhelming  majority  of  respondents  who 
suffered from COVID-19 did not take antibiotics (76%), while 
from  those  who  took,  only  4%  took  them  without  a  medical 
prescription. 

  An  analysis  at  the  national 

level 

indicates  notable 

differences among different Member States.  

  In 20 Member States, a majority of respondents indicate that 
they did not get COVID-19. They are most likely to say this in 
Finland  (80%),  Malta  (79%),  and  Germany  (77%),  and  least 
likely to say so in Poland (43%), Slovakia (44%), and Bulgaria 
(46%). 

37  QC16.  If  you  suffered  from  COVID-19,  did  you  take  any  antibiotics?  (MULTIPLE 
ANSWERS  POSSIBLE):  No,  I  did  not  take  any  antibiotics;  Yes,  from  a  medical 
prescription; Yes, administered by a medical practitioner (e.g. in hospital, in a clinic); 

Yes,  I  had  some  left  over  from  a  previous  course;  Yes,  without  prescription  from  a 
pharmacy;  Yes,  without  prescription  from  elsewhere;  I  did  not  get  COVID-19;  Don't 
remember (SPONTANEOUS); Refusal (SPONTANEOUS); Don't know.  

27 

 
 
 
 
Special Eurobarometer 522 
February - March 2022 

Almost three in ten (28%) Europeans report a decreased need 
for  antibiotics  because  of  lower  cases  of  illness  due  to 
strengthened protective measures38 

  Over  a  quarter  (28%)  of  respondents  say  the  COVID-19 
decreased their need for antibiotics because they fell ill less 
often due to strengthened personal protective measures, such 
as masks, physical distancing and stronger hand hygiene. 

  Close  to  one  in  five  (17%)  say  it  decreased  their  need  for 
antibiotics because they fell ill less often during the lockdown 
period. 

In  addition,  respondents  note  restricted  access  to  antibiotics  as 
they either could not go to the doctor to get a prescription or go to 
a pharmacy (both 6%).  

  Over  a  quarter  (27%)  of  respondents  say  their  need  for 
antibiotics  remained  the  same.  Close  to  one  in  ten  (8%) 
indicate that they do not know.  

At the national level, notable differences exist among different 
Member States.  

In two Member States, more than half of the respondents say the 
COVID-19  pandemic  decreased  their  need  for  antibiotics 
because they fell ill less often due to strengthened personal 
protective  measures:  Malta  (58%)  and  Luxembourg  (51%). 
Respondents were also likely to say this in Sweden (44%), Greece 
(43%), Italy (42%), and Croatia (40%). They are least likely to say 
this in Portugal (17%), France (18%), and the Netherlands. (21%).  

38  QC17.  What  kind(s)  of  impact  did  the  COVID-19  pandemic  have  (e.g.  due  to 
restrictions,  new  personal  protective  measures,  such  as:  hand  hygiene,  masks,  and 
physical distancing) on your need to take antibiotics? (MULTIPLE ANSWERS POSSIBLE): 
It increased my need for antibiotics; It restricted my access to antibiotics as I couldn't 
go to the doctor to get a prescription; It restricted my access to antibiotics as I couldn't 
go to the pharmacy; It decreased my need for antibiotics because I fell ill less often 

during the containment period; It decreased my need for antibiotics because I fell ill 
less often due to strengthened personal protective measures; My access to antibiotics 
remained  the  same  (SPONTANEOUS);  My  need  for  antibiotics  remained  the  same 
(SPONTANEOUS); Don't remember (SPONTANEOUS); Refusal (SPONTANEOUS); Don't 
know. 

28 

QC17 What kind(s) of impact did the COVID-19 pandemic have (e.g. due to restrictions, new personal protective measures, such as: hand hygiene, masks, and physical distancing) on your need to take antibiotics?  (MULTIPLE ANSWERS POSSIBLE)(% -EU)2817663927228051015202530February/March 2022It decreased my need for antibiotics because I fell ill less often due to strengthened personal protective measuresIt decreased my need for antibiotics because I fell ill less often during the containment periodIt restricted my access to antibiotics as I couldn't go to the doctor to get a prescriptionIt restricted my access to antibiotics as I couldn't go to the pharmacyIt increased my need for antibioticsMy access to antibiotics remained the same (SPONTANEOUS)My need for antibiotics remained the same (SPONTANEOUS)Don't remember (SPONTANEOUS)Refusal (SPONTANEOUS)Don't know 
 
 
 
 
 
CONCLUSION  

In order to slow down and reduce antimicrobial resistance which is 
a major threat to public health in Europe and the world, it is vital 
to reduce the overuse and misuse of antibiotics. The knowledge, 
attitude,  and  behaviour  of  the  general  public  play  a  key  role  in 
ensuring prudent use of antimicrobials.  

and an even larger proportion know that antibiotics should only be 
stopped  after  completing  the  full  course,  only  half  know  that 
antibiotics  are  ineffective  against  viruses.  While  six  in  ten  are 
aware that they are ineffective against colds, there was a small 
decrease in comparison with 2018.  

Between  2018  and  2022,  there  has  been  a  further  substantial 
decrease in the proportion of Europeans taking antibiotics in the 
previous 12 months, now at its lowest level since 2009 (40% in 
2009, 32% in 2018, and 23% in 2022). 

The reported use of antibiotics during the past year varies widely 
by  Member  State,  ranging  from  just  over  four  in  ten  citizens  in 
Malta  to  around  one  in seven  in  Sweden and  Germany.  While in 
almost  all  Member  States  the  proportion  of  citizens  using 
antibiotics decreased markedly, a small increase is seen in Malta. 
There are certain groups of people who are slightly more likely to 
say  that  they  have  taken  antibiotics  in  the  last  year,  such  as 
women,  those  who  finished  their  full-time education  at an  early 
age  (aged  15  or  under),  those  who  are  not  working,  and  people 
who struggle to pay their household bills. Of those who have taken 
antibiotics,  over  half  (53%)  say that  they  did  not  have a  test  to 
find out what was causing the illness at the time.  

While the vast majority (92%) of respondents obtained their last 
course of antibiotics from a healthcare professional, either via a 
medical prescription (74%) or directly from a medical practitioner 
(18%), around 8% of antibiotics were taken without a prescription 
– a similar proportion as in 2018.  

Respondents are most likely to cite a urinary tract infection (15%), 
a  sore  throat  (13%)  and  bronchitis  (12%).  About  one  tenth  of 
respondents still took antibiotics for cold (11%) or a flu (10%) and 
another 9% also report taking antibiotics for Covid-19 – diseases 
which are generally caused by viruses, not bacteria, and for which 
antibiotics  are  ineffective  unless  there  is  a  secondary  bacterial 
infection.  Fourteen  per  cent  cite  ‘other’  unspecified  reasons.  The 
proportion  of  antibiotics  taken  for  cold  (11%)  or  flu  (10%)  was 
about  the  same  (8%  and  12%  respectively)  as  in  2018.  Overall, 
still a relatively large proportion of Europeans (30%) seem to have 
taken antibiotics wrongly, for viral infections.  

Overall,  Europeans’  knowledge about  antibiotics leaves room  for 
improvement.  Only  close  to  three  in  ten  Europeans  correctly 
answer  the  four  questions  used  to  measure  respondents’ 
knowledge.  Significant  variations  are  noted  between  Member 
States, ranging from just over half of citizens in Finland who are 
able  to  do  so,  to  less  than  one  in  ten  (8%)  in  Romania. 
Encouragingly,  knowledge  appears  to  have  improved  in  most 
Member  States,  declining  slightly  in  only  three  Member  States 
compared to 2018. The socio-demographic groups who are more 
likely to lack knowledge about antibiotics are generally the groups 
who are also more likely those who are struggling to pay household 
bills.  

While  a  large  majority  (82%)  of  Europeans  are  aware  that 
unnecessary  use  of  antibiotics  makes  them  become  ineffective, 

A large majority (79%) of Europeans say they would like further 
information  on  antibiotics,  a  sharp  increase  compared  to  2018. 
Close to one in three mention wanting more information regarding 
the  medical  conditions  for  which  antibiotics  are  used,  with  the 
same proportion saying this regarding links between the health of 
humans, animals and the environment and how to use antibiotics, 
and similar proportions mention resistance to antibiotics, as well 
as how to use antibiotics. 

in  the 

A  large  majority  of  Europeans  do  not  remember  getting  any 
information 
last  year  about  not  taking  antibiotics 
unnecessarily. Just over one in five say that they did. Differences 
exist  among  Member  States.  Finland  is  the  only  Member  State 
where at least half of the respondents remember receiving such 
information.  Those  who  have  been  exposed  to  such  information 
are notably more likely to have better knowledge about antibiotics, 
although just over one in three say that the information led them 
to change their views on antibiotics.  

Europeans  perceive  doctors  and  pharmacists  to  be  the  most 
trustworthy sources of such information regarding antibiotics. This 
makes  them  well-placed  to  educate  citizens  who  are  less  well-
informed about antibiotics and more likely to be using them. The 
findings also show that family or friends, unofficial health-related 
websites, blogs and online social media, and television can and do 
convey  information  on  antibiotics.  Any  campaign,  regardless  of 
which  channel  they  use,  need  to  be  particularly  effective  at 
targeting those with poor knowledge. EU guidelines that task those 
who play a role in antimicrobial use with the promotion of prudent 
use  of  antibiotics  are  crucial  in  this  respect.  There  is  also  an 
opportunity for healthcare systems to increase diagnostic testing 
before prescribing antibiotics. As in 2018, there are, in 2022, still 
16 Member States where less than half of the citizens who took 
antibiotics had been tested to diagnose their symptoms and illness, 
leading to potentially unnecessary antibiotic courses.  

Regarding the policy response for tackling antimicrobial resistance, 
opinions are divided, although Europeans are most likely to think 
that action at a global level is most effective, followed by action 
at a national level or at the individual or family level.  

Overall, the overwhelming majority of respondents who suffered 
from  COVID-19  did  not  take  antibiotics (76%), while  from  those 
who took, only 4% took them without a medical prescription. 

Although  some  progress  was  made  between  2018  and  2022, 
reducing  the  overuse  and  misuse  of  antibiotics  remains  a 
challenge.  Improving  public  awareness  about  antibiotics  and 
antimicrobial resistance is crucial to the achievement of high levels 
of human health protection across the EU.  

29 

 
 
Special Eurobarometer 522 
Technical Specifications 
February – March 2022 

TECHNICAL SPECIFICATIONS 

Between  the  21st  of  February  and  21st  of  March  2022,  Kantar 
carried  out  wave  97.1  of  the  EUROBAROMETER  survey,  at  the 
request  of  the  European  Commission,  Directorate-General  for 
Communication, “Media monitoring and Eurobarometer” Unit. 

Wave 97.1 covers the population of the respective nationalities of 
the  European  Union  Member  States,  resident  in  each  of  the  27 
Member States and aged 15 years and over. 

The basic sample design applied in all countries and territories is a 
multi-stage, random (probability) one. In each country, a number 
of  sampling  points  were  drawn  with  probability  proportional  to 
population  size  (for  a  total  coverage  of  the  country)  and  to 
population density. 

In order to do so, the sampling points were drawn systematically 
from each of the "administrative regional units", after stratification 
by individual unit and type of area. They thus represent the whole 
territory  of  the  countries  surveyed  according  to  the  EUROSTAT 
NUTS  II  (or  equivalent)  and  according  to  the  distribution  of  the 
resident  population  of  the  respective  nationalities  in  terms  of 
metropolitan, urban and rural areas1.  

In  each  of  the  selected  sampling  points,  a  starting  address  was 
drawn,  at  random.  Further  addresses  (every  Nth  address)  were 
selected by standard "random route" procedures, from the initial 
address. In each household, the respondent was drawn, at random 
(following  the  "closest  birthday  rule").  If  no  one  answered  the 
interviewer in a household, or if the respondent selected was not 
available (not present or busy), the interviewer revisited the same 
household up to three additional times (four contact attempts in 
total). Interviewers never indicate that the survey is conducted on 
behalf  of  the  European  Commission  beforehand;  they  may  give 
this information once the survey is completed, upon request. 

The  recruitment  phase  was  slightly  different  in  the  Netherlands, 
Finland,  and  Sweden.  In  these  countries,  a  sample  of  addresses 
within each areal sampling point (1km2 grid) were selected from 
the address or population register (in Finland, selection is not done 
in  all  sample  points,  but  in  some  where  response  rates  are 
expected  to  improve).  The  selection  of addresses  was  done  in  a 
random  manner.  Households  were  then  contacted  by  telephone 
and recruited to take part in the survey. In the Netherlands a dual 
frame RDD sample (mobile and landline numbers) are used. The 
selection of numbers on both frames is done in a random manner 
with each number getting an equal probability of selection. Unlike 
Sweden and Finland, the sample is un-clustered. 

1 Urban Rural classification based on DEGURBA 
(https://ec.europa.eu/eurostat/web/degree-of-urbanisation/background)   

  TS1 

 
 
 
 
 
 
Special Eurobarometer 522 
Technical Specifications 
February – March 2022 

  TS2 

 
 
 
 
 
 
Special Eurobarometer 522 
Technical Specifications 
February – March 2022 

Recruitment for online interviews 

The  online  design  in  each  country  differed  based  on  what  was 
feasible  within  the  fieldwork  period.  Where  feasible,  the  online 
sample  was  based  on  a  probabilistic  sample  design.  Those 
recruited  to  the  online  survey  were  recruited  through  a  single 
mobile frame or dual frame Random Digit Dialling (RDD) design. In 
this way the entire phone owning population in each country had a 
non-zero chance of being sampled. The choice of whether to use a 
single  mobile  frame  or  dual  frame  (mobile  and  landline)  was 
dependent  on  the  countries’  landline  infrastructure.  Where  the 
landline infrastructure is suitably advanced to support a significant 
minority  of  residential  households  with  landline  phones  a  dual 
frame design is employed. The mix of mobile and landline sample 
is  designed  to  maximise  the  representation  of  the  responding 
sample. The RDD sample for both the mobile and landline sample 
is  drawn  from  the  country’s  telephone  numbering  plan.  The 
landline  sample  frame  is  stratified  by  NUTS3  regions  based  on 
their  prefix  and  the  mobile  by  operator  before  a  systematic 
random sample of numbers is generated proportional in size to the 
total  generatable  numbers  in  each  stratum.  Respondents  were 
recruited  using  this  sample  design  in  Belgium,  Czechia,  Estonia, 
Latvia, Luxembourg, Malta and Slovenia.  

In  Finland,  Denmark,  and  Sweden,  RDD  samples  were  not  used, 
instead  the  telephone  sample  was  drawn  from  the  country 
telephone  directory.  In  these  three  countries  the  telephone 
directories  offer  comprehensive  coverage  of  the  phone  owning 
population,  storing  both  landline  and  mobile  phone  numbers  for 
each individual.  

Response rates 

For  each  country  a  comparison  between  the  responding  sample 
and  the  universe  (i.e.  the  overall  population  in  the  country)  is 
carried out. Weights are used to match the responding sample to 
the universe on gender by age, region and degree of urbanisation. 
For European estimates (i.e. EU average), an adjustment is made 
to the individual country weights, weighting them up or down to 
reflect  their  15+  population  as  a  proportion  of  the  EU  15+ 
population.  

The response rates are calculated by dividing the total number of 
complete interviews with the number of all the addresses visited, 
apart  from  ones  that  are  not  eligible  but  including  those  where 
eligibility  is  unknown.  For  wave  97.1  of  the  EUROBAROMETER 
survey, the response rates for the EU27 countries, calculated by 
Kantar, are: 

Consequences of the coronavirus pandemic on fieldwork 

Face-to-face interviewing  

Where feasible, interviews were conducted face to face in people's 
homes  or  on  their  doorstep  and  in  the  appropriate  national 
language.  In  all  countries  and  territories  where  face-to-face 
interviewing  was  not  feasible  CAPI  (Computer  Assisted  Personal 
Interviewing) was used.  

For  face-to-face  all  interviews  conducted,  hygiene  and  physical 
distancing  measures  were  respected  at  all  times  in  line  with 
government  regulations,  and whenever  possible,  interviews were 
conducted outside homes, on doorsteps,  in order to stay  outside 
and maintain social distance.  

Face-to-face and online interviewing  

In Belgium, Czechia, Denmark, Estonia, Latvia, Luxembourg, Malta, 
Slovenia, Slovakia, Finland and Sweden, face-to-face interviewing 
was feasible, but it was not possible to reach the target number of 
face-to-face  interviews  within  the  fieldwork  period  due  to  the 
impact of COVID-19 restrictions: many potential respondents are 
reluctant to open their homes to interviewers, even if they respect 
hygiene rules and physical distancing, such as wearing masks and 
using  hydroalcoholic  gel.  Therefore,  to  hit  the  target  number  of 
interviews within the fieldwork period, additional interviews were 
conducted online with Computer-Assisted Web Interviewing (CAWI) 
technique. 

  TS3 

 
 
 
 
 
 
Special Eurobarometer 522 
Technical Specifications 
February – March 2022 

  TS4 

CAPICAWIResponse ratesResponse ratesBEBelgium50.4%15.8%BGBulgaria46.3%CZCzechia44.5%30.8%DKDenmark46.8%17.8%DEGermany22.1%EEEstonia35.4%20.7%IEIreland43.0%ELGreece28.3%ESSpain33.9%FRFrance32.1%HRCroatia40.9%ITItaly42.4%CYRep. Of Cyprus43.3%LVLatvia42.8%19.4%LTLithuania42.4%LULuxembourg29.0%46.4%HUHungary58.8%MTMalta92.4%21.3%NLNetherlands73.0%ATAustria43.6%PLPoland46.3%PTPortugal37.4%RORomania56.9%SISlovenia45.7%35.3%SKSlovakia62.9%21.2%FIFinland56.7%33.1%SESweden70.2%24.7%COUNTRIESCAPI : Computer-Assisted Personal interviewingCAWI : Computer-Assisted Web interviewing (CAWI RRs do not include the recruitment phase)  
 
 
 
 
 
 
 
 
Special Eurobarometer 522 
Technical Specifications 
February – March 2022 

Margins of error 

Readers  are  reminded  that  survey  results  are  estimations,  the 
accuracy of which, everything being equal, rests upon the sample 
size  and  upon  the  observed  percentage.  With  samples  of  about 
1,000  interviews,  the  real  percentages  vary  within  the  following 
confidence limits: 

  TS5 

various sample sizes are in rowsvarious observed results are in columns5%10%15%20%25%30%35%40%45%50%95%90%85%80%75%70%65%60%55%50%N=506,08,39,911,112,012,713,213,613,813,9N=50N=5001,92,63,13,53,84,04,24,34,44,4N=500N=10001,41,92,22,52,72,83,03,03,13,1N=1000N=15001,11,51,82,02,22,32,42,52,52,5N=1500N=20001,01,31,61,81,92,02,12,12,22,2N=2000N=30000,81,11,31,41,51,61,71,81,81,8N=3000N=40000,70,91,11,21,31,41,51,51,51,5N=4000N=50000,60,81,01,11,21,31,31,41,41,4N=5000N=60000,60,80,91,01,11,21,21,21,31,3N=6000N=70000,50,70,80,91,01,11,11,11,21,2N=7000N=75000,50,70,80,91,01,01,11,11,11,1N=7500N=80000,50,70,80,90,91,01,01,11,11,1N=8000N=90000,50,60,70,80,90,91,01,01,01,0N=9000N=100000,40,60,70,80,80,90,91,01,01,0N=10000N=110000,40,60,70,70,80,90,90,90,90,9N=11000N=120000,40,50,60,70,80,80,90,90,90,9N=12000N=130000,40,50,60,70,70,80,80,80,90,9N=13000N=140000,40,50,60,70,70,80,80,80,80,8N=14000N=150000,30,50,60,60,70,70,80,80,80,8N=150005%10%15%20%25%30%35%40%45%50%95%90%85%80%75%70%65%60%55%50%Statistical Margins due to the sampling process(at the 95% level of confidence)