Objective  To explore the cognition on antibiotic restriction policy and antimicrobial use among adult residents in Xuzhou municipality of Jiangsu province and to provide references for promoting appropriate application of antibiotics.

  Methods  We carried out a self-administered questionnaire survey among 651 permanent adult residents recruited with stratified cluster random sampling in 2 urban communities and 2 rural towns of Xuzhou municipality between September and November, 2017.

  Results  Of all the participants, 65.6% reported the awareness about the antibiotic restriction policy set by national health administration; among the participants reporting the awareness, 91.8% did not know the details of the policy and 54.6% were aware of the polity through television programs and internet. More than a half of the participants (53.1%) considered that the implementation of the antibiotic restriction policy had an obvious influence on medical service, while 46.9% of the participants did not realize the effect of the implementation of the policy. For all the participants, 38.7% considered that there was a decrease in antibiotic use after the implementation of antibiotic restriction policy but 16.5% did not report the decrease and 44.8% did not notice the situation of antibiotic use. The self-reported proportions of the participants having too little and a general knowledge about antimicrobial were 40.7% and 54.7% and only 4.6% of the participants reported having comprehensive knowledge about antimicrobial.

  Conclusion  The cognition on antibiotic restriction policy and the knowledge about antimicrobial are at a general level among urban and rural adult residents of Xuzhou municipality and the implementation effect of antibiotic restriction policy should be improved.