Knowledge, Attitude, and Practice Towards Antibiotic Use and Resistance Among Non-Medical University Students, Riyadh, Saudi Arabia

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.
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.

• When it came to the field of study, the majority were enrolled in business programs (34.1%).
• Domains with less than 0.07 were reviewed carefully, and targeted questions were modified or deleted accordingly.
• 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 .
• All the questionnaires were reviewed before entering the data into the analysis program.
• A 60% proficiency threshold—determined through pilot study analyses (mean and median of knowledge scores)—was adopted to assess adequacy across domains.
• It was piloted among 5% of the sample (35 students).
• Addressing these issues should be prioritized as an antimicrobial stewardship strategy as these students are crucial, tentative frontliners in healthcare administration in the country.

3.4. Data Presentation and Analysis

Focusing on non-medical students is critical, as they represent a high-risk demographic for antibiotic misuse due to their lack of formal medical training, potential role in shaping public health behaviors, and limited awareness of AR consequences. Similarly, Mostafa et al. (2021) found that Egyptian university students demonstrated low health literacy and limited knowledge about antibiotics, increasing the likelihood of misuse . 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. Overall, 77.3% demonstrated adequate knowledge, 67.4% positive attitudes, and 49.4% good practices toward antibiotic use.
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.

Data safety

Females had 65.8% higher odds of demonstrating a positive attitude toward AR prevention, compared to males, and 52% higher odds of adopting appropriate practices than males. Abstract Introduction Antibiotic misuse is a growing global concern as it exacerbates antimicrobial resistance (AMR) and in Ghana, antibiotic misuse persists. The focus on non-medical students addressed literature gaps, while standardized, WHO-aligned questions minimized variability and improved global comparability. Students in science and engineering disciplines demonstrated stronger knowledge and more responsible practices than peers in other fields, underscoring the influence of scientific training in curricula.

2. Study Design and Settings

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 https://www.betsomnia-nl.nl/ 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.

Associated Data

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 .

• Verbal informed consent was obtained from all participants, detailing the study’s purpose, procedures, risks, and benefits.
• Key strengths include a robust, gender-balanced sample of non-medical Riyadh students, enhancing statistical power and representativeness.
• Copyrights and related rights for article metadata waived via CC0 1.0 Universal (CC0) Public Domain Dedication.
• Younger students (19–20 years) emerged as a critical subgroup requiring early intervention during their formative academic years.
• The aim of this study was to investigate the knowledge and awareness of appropriate antibiotic use among 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.

As an integral and educated segment of society, students 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.
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.

3.2. Data Collection Instrument

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.