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.

Published in Discover Public Health

When it came to the field of study, the https://www.betsomnia-nl.nl/ majority were enrolled in business programs (34.1%). 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%). All the questionnaires were reviewed before entering the data into the analysis program.

• Al Nasser et al. (2021) reported that while people may possess some knowledge about antibiotics, they often exhibit negative attitudes toward their use .
• 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 .
• The effective sample size calculated was 334; however, a larger sample size of 501 students was eventually included in the study, yielding approximately 1.5 times the initial sample size projection (1.5 design effect).
• Al-Shibani et al. (2017) found that self-medication with antibiotics, even for minor illnesses like sore throats, is common in Riyadh .
• 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 .
• 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).

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.
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.

3.4. Data Presentation and Analysis

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.

Associated Data

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.

• The focus on non-medical students addressed literature gaps, while standardized, WHO-aligned questions minimized variability and improved global comparability.
• Targeted education is crucial to improve antibiotic awareness, especially among specific demographics.
• Such initiatives would bridge technical expertise with public health priorities, positioning engineers as advocates for antibiotic stewardship.
• Age significantly impacted antibiotic-related attitudes and practices among students.
• Family/siblings or friends provided information for 7.0% (47 participants), while social media was a source for 6.8% (46 participants).

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).

Knowledge, attitudes and practices of antibiotic use among students in a Ghanaian tertiary institution

This study provides vital data for public health initiatives and informs effective strategies to promote responsible antibiotic use. This study reveals a significant lack of knowledge and understanding about AR among non-medical university students. The Center for Disease Control and Prevention (CDC) and other global health agencies advocate for integrated public health strategies to fight MDROs, particularly among university students.
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.

3. Sample Size

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.
The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. Targeted education is crucial to improve antibiotic awareness, especially among specific demographics. First, the reliance on self-reported data introduces risks of recall bias (e.g., inaccuracies in recalling past antibiotic use) and social desirability bias (over reporting adherence to guidelines), potentially compromising the validity of responses. These elements collectively strengthen insights into antibiotic awareness in an understudied demographic. Key strengths include a robust, gender-balanced sample of non-medical Riyadh students, enhancing statistical power and representativeness. The results advocate for tailored educational programs to enhance antibiotic awareness, particularly in demographics where age, gender, and academic discipline significantly influence outcomes.

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.