Objectives To explore patients’ or parents of child patients’ understanding of antibiotic resistance and aspects of resistance such as resistance reversibility and its spread among those in close proximity, along with how this may influence attitudes towards antibiotic use for acute respiratory infections (ARIs).

Design Qualitative semistructured interview study using convenience sampling and thematic analysis by two researchers independently.

Setting General practices in Gold Coast, Australia.

Participants 32 patients or parents of child patients presenting to general practice with an ARI.

Results Five themes emerged: (1) antibiotic use is seen as the main cause of antibiotic resistance, but what it is that becomes resistant is poorly understood; (2) resistance is perceived as a future ‘big problem’ for the community, with little appreciation of the individual impact of or contribution to it; (3) poor awareness that resistance can spread between family members but concern that it can; (4) low awareness that resistance can decay with time and variable impact of this knowledge on attitudes towards future antibiotic use and (5) antibiotics are perceived as sometimes necessary, with some awareness and consideration of their harms.

Conclusions Patients’ or parents of child patients’ understanding of antibiotic resistance and aspects of it was poor. Targeting misunderstandings about resistance in public health messages and clinical consultations should be considered as part of a strategy to improve knowledge about it, which may encourage more consideration about antibiotic use for illnesses such as ARIs.