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.
Associated Data
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).
2. Study Design and Settings
While our study primarily focused on university students within Riyadh, we acknowledge that nationality could indeed play a role. Students from literary fields were the most likely to have insufficient knowledge, attitudes, and practices, while those in science and engineering showed better outcomes. While overall awareness and behavior appear positive, nearly four in ten students lack proper understanding and engagement in AR practices. The study converted all antibiotic-related knowledge, attitude, and practice scores into percentages to standardize scoring and classify proficiency levels.
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.
Participants scoring above 60% were deemed to have adequate KAP, whereas those at or below this threshold were categorized as having insufficient understanding or behaviors in antibiotic use. Knowledge-related questions were scored with a binary system, where incorrect or uncertain (“don’t know”) responses received a score of 0, while correct answers were awarded 1 point. Domains with less than 0.07 were reviewed carefully, and targeted questions were modified or deleted accordingly. It was piloted among 5% of the sample (35 students). Data collection was conducted from 4 September to 19 October 2023 by a team of trained students from the College of Medicine at AlMaarefa University, who followed standardized protocols for accuracy and consistency. This in-person approach ensured direct participant engagement, comprehensive responses, and efficient data collection.
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.
3. Sample Size
Additionally, https://www.betsomnia-nl.nl/ many individuals discontinue antibiotics as soon as they feel better rather than completing the full course, further exacerbating AR risks. Al-Shibani et al. (2017) found that self-medication with antibiotics, even for minor illnesses like sore throats, is common in Riyadh . In 2018, the Saudi Ministry of Health (MOH) implemented a national policy requiring a prescription for all antibiotic sales in pharmacies, aiming to curb the misuse of antimicrobials. Antimicrobial resistance (AMR) poses an urgent global health crisis, contributing to approximately 700,000 deaths worldwide annually.
- The aim of this study was to investigate the knowledge and awareness of appropriate antibiotic use among university students.
- 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.
- Key strengths include a robust, gender-balanced sample of non-medical Riyadh students, enhancing statistical power and representativeness.
- Age is one factor linked to less responsible antibiotic behaviors, suggesting certain groups are more prone to misuse.
- Verbal informed consent was obtained from all participants, detailing the study’s purpose, procedures, risks, and benefits.
- Our study revealed a lack of knowledge regarding the safe use of antibiotics and inadequate medical practices related to their consumption among the population.
A national study on Gram-positive bacteria in Saudi Arabia revealed alarming resistance trends. The NAP is structured around five sub-committees dedicated to raising awareness, monitoring resistance patterns, strengthening infection control, optimizing antibiotic use, and advancing research. This comprehensive strategy aligns with the World Health Organization’s (WHO) Global Action Plan and focuses on multi-sectoral collaboration, evidence-based interventions, and enhancing awareness of AMR among both the public and healthcare professionals 6,7. The primary source of information on antibiotics was healthcare professionals, particularly doctors.
Published in Discover Public Health
Students may lack awareness of pharmacists’ expertise, highlighting an opportunity to diversify accessible, trusted healthcare sources for public education. However, expanding awareness to include pharmacists—equally qualified to educate on antibiotic use and resistance—is critical. Such contradiction is probably due to the inclusion in their sample with all age groups rather than a young population of university students . As depicted in Table 1, among the 672 participants involved in this study, the mean age of the students was 20.2 years ±standard deviation (SD) 1.8.
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. The sample was then proportionally allocated to each university. A multistage sampling method was used, first stratifying Riyadh universities as public or private (three universities for each). This study adhered to strict ethical guidelines. These findings highlight the pressing need for sustained antimicrobial stewardship efforts and strict enforcement of antibiotic regulations to mitigate the growing threat of AMR in the region.
- 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.
- Level of knowledge, attitude, and practice toward AR among the university students.
- 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.
- Misconceptions persisted, with 13.3% believing antibiotics treat viral infections and 44.2% considering all antibiotics safe.
- However, 40.9% of students demonstrated insufficient knowledge, and factors such as age, gender, and field of study significantly impacted KAP outcomes.
- 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.
- 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.
2. Study Design and Settings
The aim of this study was to investigate the knowledge and awareness of appropriate antibiotic use among university students. The study highlights persistent knowledge gaps about AR among non-medical university students in Riyadh, despite moderate general awareness. This study found that non-medical students at Riyadh universities demonstrate strong awareness of antibiotic use information sources, with 76% relying primarily on physicians—a rate markedly higher than the 38% observed among Malaysian university students . Our study revealed a lack of knowledge regarding the safe use of antibiotics and inadequate medical practices related to their consumption among the population.