Abstract
BACKGROUND: Antimicrobial resistance (AMR) represents a growing challenge to both individual and public health, driven by the excessive and inappropriate use of antibiotics. Studies emphasize a widespread lack of knowledge regarding proper antibiotic use and the mechanisms of antibiotic resistance. This study aims to explore the relationships between citizens' health engagement and attitudes towards antibiotic consumption (Hypothesis 1, Hypothesis 2) and explores the role of orientation to health literacy as a mediator of these relationships (Hypothesis 3). METHODS: Data were collected via a questionnaire administered to a representative sample of the Italian population (N = 1016). Descriptive statistics and mediation analysis, using bootstrapping with 5000 resamples to estimate indirect effects and assess statistical significance. RESULTS: All hypotheses were confirmed. Health engagement had a significant, positive effect on orientation to health literacy, which was positively associated with attitudes towards antibiotic consumption. Moreover, orientation to health literacy fully mediated the effect of health engagement on attitudes towards antibiotic consumption. CONCLUSIONS: This study highlights the crucial role of health literacy in influencing attitudes towards appropriate antibiotic consumption. Public health interventions should not only encourage individuals to actively engage with their health, but also focus on improving their health literacy, including on specific topics such as AMR.