Background Life satisfaction, as a measure of subjective wellbeing, has both positive and negative effects on health risks and social behavior. However, the associations between life satisfaction and knowledge, attitudes, and frequency of use related to antibiotic use and antimicrobial resistance are unclear. Methods A cross-sectional study (n = 1230) was conducted in three neighboring cities in the Greater Bay Area (Hong Kong, Shenzhen, and Guangzhou). The Personal Wellbeing Index–Adult (PWI-A) was used to assess life satisfaction, which includes a measure of overall life satisfaction and additional measures for seven specific domains: standard of living, personal health, achievement in life, personal relationships, personal safety, community connectedness, and future security. Descriptive statistics were used to compare 1) knowledge, attitudes, and frequency of use related to antibiotic use and antimicrobial resistance and 2) life satisfaction among individuals from the three cities. Regression analyses were conducted to assess the associations between life satisfaction and antibiotic-related knowledge, attitudes, and frequency of use. Results Personal health and personal safety were positively associated with knowledge of antibiotic use and antimicrobial resistance (β = 0.110 [0.028, 0.191] and 0.083 [0.001, 0.164]). Standard of living and achievement in life were negatively associated with knowledge (β = −0.097 [−0.188, −0.007] and −0.109 [−0.205, −0.012]) and attitudes (β = −0.107 [−0.190, −0.024] and −0.178 [−0.264, −0.093]). In addition, standard of living and achievement in life were positively associated with antibiotic use (ORs = 1.239 [1.127, 1.361] and 1.214 [1.108, 1.330]), whereas personal health was negatively associated with antibiotic use (OR = 0.848 [0.776, 0.927]). City contributed a fixed effect on knowledge independent of personal wellbeing, and differences in the associations between personal wellbeing and KAP across cities were mainly observed in the results for antibiotic use. Conclusion Subjective socioeconomic status may negatively influence knowledge, attitudes, and practices regarding antibiotic use and antimicrobial resistance, which in turn affects medication decisions and risk perceptions among local residents.
