Antibiotic resistance caused by antibiotic abuse has become a public health issue worldwide. Reducing the irrational use of antibiotics for upper respiratory tract infections (URTIs) among the public is an important strategy to address the antibiotics abuse in China. Therefore, identifying the characteristics of URTIs in the population and their influence on the irrational use of antibiotics can help to design more targeted policies and interventions.

To quantify the potential patterns of symptoms of URTIs in the pulic, and explore their effect on antibiotic use behavior.

The public in three counties (districts) of Chongqing Municipality from July 20 to August 2, 2022 were selected as the survey respondents by using the cluster random sample method. The symptoms of URTIs, antibiotic use behavior, antibiotic use knowledge and demographics of the public were collected. Latent class analysis was used to identify the potential patterns of the public URTIs symptoms. Multivariate Logistic regression analysis was used to explore the influence of URTIs potential patterns on antibiotic use behavior.

In this study, a total of 815 participants were included. Among them, 30.06% (245/815) of the respondents purchased antibiotics from pharmacies without a prescription, while 14.72% (120/815) of the respondents self-medicated with antibiotics for URTIs. The public knowledge level regarding rational antibiotic use was relatively low, with an average score of (2.3±1.7) points. Four symptom patterns for upper respiratory tract infections identified by latent class analysis regarding the disease pattern of URTIs, including 93 cases (11.41%) in the diverse symptoms group, 124 (15.21%) cases in the systemic symptoms group, 282 cases (34.60%) in the nasalpharyngeal symptoms group, and 316 cases (38.77%) in the mild symptoms group. The results of multivariate Logistic regression analysis showed that compared with the mild symptoms group, the nasal-pharyngeal symptoms group had a higher probability of purchasing antibiotics without a prescription (OR=1.538, P<0.05) and the association remained significant after adjusting for knowledge and demographic variables. In addition to the potential patterns of individual disease symptoms, age and medical insurance type also had a significant impact on the non-prescription antibiotic purchasing behavior of the public (P<0.05). There was a significant effect of antibiotic usage knowledge level on self-medication behavior with antibiotics (OR=0.869, P<0.05) and non-prescription antibiotic purchasing behavior of the public (OR=1.155, P<0.05) .

There are four potential patterns of symptoms of URTIs in the public. Patterns of disease symptoms significantly influence the rational use of antibiotics by the public. The focus should be on the irrational use of antibiotics in patients presenting with nasopharyngeal symptoms.