Background: Adverse drug reactions (ADRs) significantly impact patient safety and healthcare costs worldwide, making pharmacovigilance a critical public health function. Despite national initiatives like the Pharmacovigilance Programme of India (PvPI), public awareness regarding ADR recognition and reporting remains low, particularly in rural and semi-urban areas. This study aimed to assess the knowledge, perceptions, and practices related to ADRs and pharmacovigilance among residents of Mandi district, Himachal Pradesh. Materials and Methods: A descriptive, cross-sectional survey was conducted from January to March 2025, targeting 400 adult residents across urban and rural areas of Mandi. Participants were selected using purposive and snowball sampling techniques. Data were collected through a structured, bilingual questionnaire covering demographics, ADR knowledge, awareness of pharmacovigilance systems, and reporting practices. Responses were scored and categorized into Very Good (≥80%), Good (60–79%), Fair (41–59%), and Poor (<40%) knowledge levels. Statistical analysis was performed using SPSS version 26.0. Results: The majority of participants were young to middle-aged adults, with a predominance of rural residents (65.3%). While 77.0% correctly identified ADRs and 79.3% recognized their potential severity, only 60.3% were aware of pharmacovigilance, and just 59.8% knew that patients could report ADRs directly to PvPI. Knowledge levels were categorized as Good in 42.8% and Very Good in 29.5% of respondents, but 27.8% demonstrated Fair or Poor understanding. Gaps were particularly notable in awareness of reporting channels, the risks of combining herbal remedies with modern medicines, and recognizing ADRs among vulnerable populations. Conclusion: Although the Mandi population exhibits encouraging foundational awareness of ADRs, critical knowledge and behavioral gaps persist, especially regarding formal reporting systems and patient-led pharmacovigilance participation. Targeted, community-based education campaigns, integration of ADR counseling in clinical practices, and the promotion of accessible, patient-friendly reporting tools are urgently needed to strengthen pharmacovigilance and improve medication safety outcomes in semi-urban and rural settings.

Background: Antibiotic resistance has emerged as a major global public health crisis, driven by decades of antibiotic misuse, overuse, and poor adherence to prescribed therapies. In India, the problem is exacerbated by easy over-the-counter access, self-medication, and widespread misconceptions, particularly in rural and semi-urban areas like Mandi district, Himachal Pradesh. Understanding public awareness and behaviors around antibiotic use is crucial for formulating effective intervention strategies. Materials and Methods: This descriptive, cross-sectional study surveyed 400 adult residents of Mandi district between January and March 2025 using a structured, bilingual questionnaire. Participants were selected through purposive and snowball sampling across urban and rural settings. Data on demographics, knowledge, perceptions, and behavioral practices regarding antibiotic use and resistance were collected via face-to-face interviews and self-administered forms. Responses were analyzed using SPSS v26.0, and knowledge levels were categorized as Very Good, Good, Fair, or Poor. Results: The study revealed that 78% correctly identified antibiotics as bacterial infection treatments, and 81.5% recognized early cessation of antibiotics as a risk factor for resistance. However, significant misconceptions persisted, with 28.2% believing antibiotics could treat viral infections and only 62.8% aware of resistance impacting future generations. Knowledge scores classified 32.3% as Very Good, 41.8% as Good, 19.0% as Fair, and 7.0% as Poor. Unsafe practices such as self-medication and reuse of leftover antibiotics were noted despite high general awareness levels, particularly among rural populations. Conclusion: While awareness of antibiotic use and resistance among Mandi residents is encouraging, critical gaps remain, particularly regarding resistance transmission and societal impact. Rural communities showed lower understanding and riskier practices. Targeted educational interventions, stricter enforcement of prescription regulations, and strengthened healthcare engagement are essential to translate knowledge into safer antibiotic behaviors and curb the growing threat of resistance.