Background and Objective:
Antimicrobial resistance (AMR) is one of the major public health threats of the 21st century. The World Health Organization has highlighted the key role of population empowerment in counteracting AMR. The aim of the study is to assess the impact of selected initiatives on public awareness of AMR using Google TrendsTM(GT) analysis.

Methods:
The impact of World Antimicrobial Awareness Week(WAAW) and World Hand Hygiene Day(WHHD) on public awareness of ‘AMR’, antibiotics and antibiotic resistance in Sweden, United States, Italy, Japan, Spain and Netherlands from 2017 to 2022 was analyzed, using the relative search volume(RSV) of GT as a surrogate. A joinpoint regression analysis was performed to identify a statistically significant time point of a change in trend. The trends in the different countries were compared by calculating the Z-score.

Results:
The analysis of the Z-scores showed a comparable upward trend in all investigated countries. The joinpoint regression did not reveal joinpoints around WAAW and WHHD. Decreasing RSVs of “antibiotics” and “AMR” were shown in all investigated countries, in the period March-May 2020, the decrease is more pronounced in Spain and Italy. In Italy, unlike to other nations, spikes in searches for the term “antibiotics” during the flu-season were displayed.

Conclusion:
Results highlight that programs taken into consideration(WAAW and WHHD) seem not to have sufficiently contributed to raise public awareness of AMR. Enhancing public awareness could help in fight against AMR, but more effective strategies to improve awareness are needed. The decreasing of RSVs during 2020 could be due to COVID-19 pandemic, in particular in Italy and Spain, countries most affected by COVID-19 among those analysed. The spike in the search for the term “antibiotics” in Italy during the flu-season suggests the opportunity to launch public health campaigns to highlight that antibiotics have no effect on the flu.