Proposed strategies include integrating AR education into university curricula, launching campus-wide campaigns (e.g., digital outreach, mandatory health literacy modules), and partnering with pharmacies to reinforce responsible practices. This suggests that the majority of participants had a moderate level of practice towards antibiotic use, similar to the reported findings from university student in Nepal and in line with the almost around the global average of 56%, according to the 2020 WHO survey . Overall, the study highlights the need for interventions to improve students’ understanding of AR and promote appropriate practices. However, nationality and university affiliation showed no significant associations across knowledge, attitude, or practice, with all p-values greater than 0.05. Specifically, 43% (289 out of 672) of the participants demonstrated an adequate understanding of antibiotic resistance, while the remaining 57% (383 out of 672) exhibited an inadequate knowledge of this topic. These behaviors increase the prevalence of resistant infections, leading to harder-to-treat diseases, higher healthcare costs, and increased outbreak risks on university campuses and within the broader community, posing a significant public health threat .
As an integral and educated segment of society, students https://www.betsomnia-nl.nl/ influence public health behaviors and community practices. A literature review identified only three studies on antibiotic KAP among healthcare students 9,10,11, with no published research on non-medical university students in Saudi Arabia 28,29,30. Public health campaigns should prioritize the 17–24 age group, as university students represent a pivotal demographic shaping health behaviors, yet are often excluded from antibiotic stewardship initiatives. Risky behaviors—such as self-medication and sharing antibiotics without prescriptions—were widespread, revealing a mismatch between partial awareness and actual practices 13,45,46,47,48,49.
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However, 40.9% of students demonstrated insufficient knowledge, and factors such as age, gender, and field of study significantly impacted KAP outcomes. Addressing these issues should be prioritized as an antimicrobial stewardship strategy as these students are crucial, tentative frontliners in healthcare administration in the country. Misconceptions persisted, with 13.3% believing antibiotics treat viral infections and 44.2% considering all antibiotics safe. Using simple random sampling, 233 students were enrolled across five health programs. Methods A cross-sectional study was conducted among undergraduate students of the Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, from May–August 2024. University students in the Allied Health Sciences are uniquely positioned to influence patterns of antibiotic use, both as practitioners and educators.
3. Sample Size
Combining prevention and response interventions is essential for effective control in healthcare settings . Family/siblings or friends provided information for 7.0% (47 participants), while social media was a source for 6.8% (46 participants). Pharmacists were the second-most common source, consulted by 9.4% (63 participants). The mean knowledge score related to AR was 63.97 ≈ 64 (±8 SD, range ≈ 49). Sociodemographic characteristics of the participants.
- Studies from England, Italy, and Cyprus highlight this trend, demonstrating that younger individuals report poorer antibiotic knowledge and higher misuse rates 15,16,17.
- Notably, students aged 19–20 demonstrated the highest rates of insufficient knowledge and unsafe behaviors compared to other age groups.
- All non-medical students in any public or private university in Riyadh, regardless of their nationalities, genders, or fields of study, were included, whereas visiting students or medical students were excluded from the study.
- Table 3 illustrates the analysis of the association between sociodemographic characteristics and sufficient knowledge, positive attitude, and appropriate practice of antibiotics among university students and reveals several significant patterns.
- Additional questions assessed understanding of antibiotic side effects and the perceived efficacy of alternative medicine as a substitute.
While these trends align with regional studies, they contrast with European data 15,16,40,50,51, likely reflecting cultural or institutional differences in health education. Factors such as cultural health beliefs, access to healthcare information, and variations in national health policies could all contribute to differences in awareness. In our Riyadh-based sample, participants were predominantly Saudi nationals, reflecting the local university demographics. Age is one factor linked to less responsible antibiotic behaviors, suggesting certain groups are more prone to misuse. Inappropriate antibiotic use, which is concerning, fuels antibiotic resistance. Since 2018, Saudi Arabia’s Ministry of Health has enforced regulations under the Health Practice Law, prohibiting pharmacists from dispensing antibiotics without a valid prescription from a licensed physician.
Al Nasser et al. (2021) reported that while people may possess some knowledge about antibiotics, they often exhibit negative attitudes toward their use . Antibiotic resistance has emerged as a critical global health challenge, driven by the widespread misuse and overuse of antibiotics, leading to the emergence of multidrug-resistant organisms (MDROs), which significantly complicate treatment options 1,2. Additionally, the absence of clinical validation—such as prescription audits or medical records—may lead to overestimations of appropriate antibiotic practices Such initiatives would bridge technical expertise with public health priorities, positioning engineers as advocates for antibiotic stewardship. Collaborations with medical or public health faculties could foster interdisciplinary solutions, empowering engineers to design innovations (e.g., wastewater treatment systems) that mitigate AMR risks. For engineering students, who demonstrated higher baseline knowledge, introducing an elective course on antibiotic awareness could leverage their scientific literacy and problem-solving skills.
3.4. Data Presentation and Analysis
Initiating a health awareness campaign can assist legislators in making informed decisions to increase awareness. However, other studies from Italy and Nepal reported a very high level of knowledge to antibiotic use compared to our findings (84.8%, 94%) 30,31. This study aims to assess the level of awareness about AR. Sources of information about the participants’ antibiotic use. The primary source of information about antibiotic use among participants was their doctor, with 76.8% (516 participants) relying on this source (Figure 1).
3.4. Data Presentation and Analysis
The present study showed that university non-medical students’ practice toward antibiotic use was approximately 60.6%. This is in contrast to other studies from Jordan, Thailand, Zambia, Brunei, Sudan, and Cyprus, where non-medical students exhibited lower levels of knowledge regarding antibiotics and antimicrobial resistance 20,21,23,24,25,26,28,29. Age significantly impacted antibiotic-related attitudes and practices among students. Level of knowledge, attitude, and practice toward AR among the university students. This scoring framework ensured consistency in evaluating participants’ antibiotic-related attitudes and practices, aligning with established methodologies to enhance reliability and comparability of results.
- This study provides vital data for public health initiatives and informs effective strategies to promote responsible antibiotic use.
- Notably, the majority of participants were in the age group 19–20 years old (36.8%), unmarried (96.0%), female (60.0%), and of Saudi nationality (94.5%).
- A convenience sampling was employed to select participants based on accessibility and willingness to participate on campus, continuing until the required sample size was met.
- Understanding public knowledge, attitudes, and practices regarding antibiotics is essential for developing effective strategies to combat AR .
- The findings also reveal critical gaps in knowledge, attitudes, and practices among such students regarding antibiotic use.
- Amoxicillin was the most commonly reported antibiotic (65.7%).
- Similarly, Mostafa et al. (2021) found that Egyptian university students demonstrated low health literacy and limited knowledge about antibiotics, increasing the likelihood of misuse .
Knowledge, attitudes and practices of antibiotic use among students in a Ghanaian tertiary institution
Data were collected using a self-administered questionnaire covering sociodemographic characteristics and KAP regarding antibiotics. Copyrights and related rights for article metadata waived via CC0 1.0 Universal (CC0) Public Domain Dedication. Amoxicillin was the most commonly reported antibiotic (65.7%). Results Out of the 233 participants, 58.8% were female and 95.7% aged 18–24 years.
On the other hand, literary students had 52.2% lower odds of sufficient knowledge compared to sciences students. Notably, students aged 19–20 demonstrated the highest rates of insufficient knowledge and unsafe behaviors compared to other age groups. In terms of university affiliation, IMSU had the highest representation, with 54.0% of participants. Although the dataset contained minimal missing values, specifically about ten instances within the attitude assessment, mean imputation was employed to address these gaps. A 60% proficiency threshold—determined through pilot study analyses (mean and median of knowledge scores)—was adopted to assess adequacy across domains. Additional questions assessed understanding of antibiotic side effects and the perceived efficacy of alternative medicine as a substitute.
This disparity aligns with the observation that science and engineering students, benefiting from biology/microbiology-rich curricula and practical lab work, demonstrate enhanced antibiotic understanding and practices, thus contributing to improved public health literacy. This study used Pearson’s Chi-Square test to explore the relationship between antibiotic knowledge, attitudes, and practices and demographic factors, after confirming the test’s assumptions, notably that expected cell frequencies were above five. Logistic regression model was computed to identify predictors of inadequate knowledge, negative attitude, and poor practices towards antibiotics use. Data on knowledge, attitudes, and practices (KAP) regarding antibiotic use were collected via a structured, pretested questionnaire.
Other statements examined self-medication behaviors, such as taking antibiotics based on past similar symptoms (e.g., toothache, gastrointestinal issues), using expired antibiotics, or discontinuing antibiotic courses prematurely upon feeling better. Additional statements addressed misconceptions, including the use of antibiotics for viral conditions (e.g., colds, flu), pain relief, fever reduction, and availability as over-the-counter drugs. The attitude section had a possible score range of 12–60, while the practice section ranged from 18–90. The attitude and practice sections utilized a five-point Likert scale (strongly disagree to strongly agree), with responses scored from 1 (least appropriate) to 5 (most appropriate). Three questions related to knowledge from the previous literature were found not appropriate to the local context and then not included in the final version of the questionnaire. A structured, paper-based, self-administered questionnaire—designed based on validated instruments from prior studies 16,31,34,35,36,37,38—was distributed as printed copies to target participants across multiple university campuses.
The findings in Table 2 indicate that the majority of university students demonstrated sufficient knowledge (59.1%), positive attitude (60.0%), and appropriate practice (60.6%) regarding antibiotic resistance. This study aimed to assess the level of knowledge, attitude, and practice (KAP) toward AR among non-medical university students in Riyadh, Saudi Arabia and identify factors that influence antibiotic use. Association between sociodemographic characteristics and sufficient knowledge, attitude, and practice of antibiotics among university students.
Attitudes toward antibiotic use were evaluated through twelve questions, including statements such as trusting a physician’s decision when choosing not to prescribe antibiotics and avoiding unnecessary antibiotic use. The questionnaire also included items on awareness of antibiotic side effects, the consequences of overuse leading to resistance, and the misconception that resistance is trivial or solely related to allergies. A content validity ration (CVR) was calculated for each domain, and all domains reported 0.73 for knowledge domain, 0.68 for attitude domain, and 0.76 for practice domain for Cronbach alpha coefficient score. By evaluating these factors, the findings can inform targeted educational interventions to promote responsible antibiotic practices, align with national antimicrobial stewardship goals, and mitigate AR spread.
Some questions reflected tendencies toward misuse, such as believing antibiotics should be accessible without a prescription, sharing them with family members without medical consultation, or using them to prevent the worsening of illness. All non-medical students in any public or private university in Riyadh, regardless of their nationalities, genders, or fields of study, were included, whereas visiting students or medical students were excluded from the study. A cross-sectional design was used to measure the level of awareness of antibiotic misuse that leads to AR among students in public and private universities of Riyadh, Saudi Arabia. However, due to limited antibiotic education, non-medical students frequently misuse antibiotics—taking them without prescriptions, using leftover medication, sharing antibiotics, or discontinuing treatment early. For example, while many refrain from sharing leftover antibiotics—considered a positive behavior—negative attitudes toward antibiotic use persist.
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