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.
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.
Data safety
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.
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.
3.4. Data Presentation and Analysis
- 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.
- 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.
- While our study primarily focused on university students within Riyadh, we acknowledge that nationality could indeed play a role.
- Inappropriate antibiotic use, which is concerning, fuels antibiotic resistance.
- University students in the Allied Health Sciences are uniquely positioned to influence patterns of antibiotic use, both as practitioners and educators.
- Recent studies indicate that many individuals lack adequate knowledge about proper antibiotic use, contributing to the spread of resistance.
- Such contradiction is probably due to the inclusion in their sample with all age groups rather than a young population of university students .
When it came to the field of study, the 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.
3. Sample Size
Further investigation into this demographic is essential for promoting responsible antibiotic stewardship and mitigating resistance on university campuses and beyond. Studies exploring self-medication, antibiotic sharing, and misconceptions among students are scarce, all of which contribute to antimicrobial resistance . Studies from England, Italy, and Cyprus highlight this trend, demonstrating that younger individuals report poorer antibiotic knowledge and higher misuse rates 15,16,17. Younger demographics, particularly university students, are globally recognized as high-risk groups for AR. Recent studies indicate that many individuals lack adequate knowledge about proper antibiotic use, contributing to the spread of resistance.
- 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 .
- When it came to the field of study, the majority were enrolled in business programs (34.1%).
- Addressing these issues should be prioritized as an antimicrobial stewardship strategy as these students are crucial, tentative frontliners in healthcare administration in the country.
- It was piloted among 5% of the sample (35 students).
- Policymakers must implement multifaceted interventions addressing healthcare and patient factors.
- A 60% proficiency threshold—determined through pilot study analyses (mean and median of knowledge scores)—was adopted to assess adequacy across domains.
Published in Discover Public Health
Additionally, 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.
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.
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.
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).
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.
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). https://www.betsomnia-nl.nl/ 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.
