BackgroundThe inappropriate use of antibiotics in pediatrics contributes to antimicrobial resistance. Behavior change intervention involving education to improve the use of antibiotics is a strategy included in antimicrobial stewardship. This study aims to evaluate and compare the impact of two educational interventions on knowledge of antibiotic and its use among pediatric home caregivers.MethodsThis was a cross-sectional study conducted in the pediatric out-patient department of a healthcare facility. A structured questionnaire was administered to sixty pediatric caregivers. Pediatric caregivers were grouped in two of 30. Caregivers in a group filled the questionnaire, and refilled the same questionnaire after a one-on-one education. The second arm refilled the questionnaire after a group education. Ethical clearance was obtained and participants gave consent. Data analysis was done using SPSS version 22 and Graph pad Instat,pvalues < 0.05 were considered significant.ResultsFouty-nine (81.7%) participants believe that antibiotics can treat malaria infection [8(13.3%) after education)], 43(71.7%) of respondents agreed that antibiotics can be used to treat all kinds of diarrhea, while 45(65%) of them thought that antibiotics in powder form can be reconstituted with hot or warm water before use [7(11.7%) after education]. Mean score among the sixty participants before and after education on knowledge and use of antibiotics were 36.1 ± 6.467 versus 46.7 ± 4.027 (p≤0.0001) and 29.82 ± 4.949 versus 36.92 ± 3.997 (p≤ 0.0001), respectively. Mean score on knowledge and use of antibiotics for one-on-one versus group education were 46.7 ± 4.027 versus 43.3 ± 6.249 (p= 0.022) and 37.9 ± 3.044 versus 35.93 ± 4.608 (p= 0.039), respectively.ConclusionsMany pediatric caregivers had poor knowledge on antibiotics and use which improved significantly after education. One-on-one education has more impact than group education. Pharmacists and other healthcare professionals can use counseling opportunity to inform caregivers on appropriate knowledge and use of antibiotics consistently to change behavior.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40545-023-00578-5.