Misuse of antibiotic therapy can have a profound negative impact both on individuals and on the community. The objective of this meta-analysis was to estimate the prevalence of antibiotic misuse in terms of non-compliance with therapy or reuse of leftover antibiotics in the community. Of 2848 screened articles, 46 contained the required information on the number of participants, the number compliant/using leftovers and the measurement technique. Mean compliance with antibiotics was 62.2% (95% confidence interval (CI), 56.4-68.0%) and mean use of leftover antibiotics was 28.6% (95% CI, 21.8-35.4%). Although variation in the methods resulted in substantial heterogeneity in the estimates, results were generally consistent by region and measurement technique. Patient education and simpler antibiotic regimens should be encouraged to promote responsible use of antibiotic therapy.