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.

• Sociodemographic characteristics of the participants.
• Overall, the study highlights the need for interventions to improve students’ understanding of AR and promote appropriate practices.
• 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.
• Domains with less than 0.07 were reviewed carefully, and targeted questions were modified or deleted accordingly.
• All the questionnaires were reviewed before entering the data into the analysis program.
• When it came to the field of study, the majority were enrolled in business programs (34.1%).

3.2. Data Collection Instrument

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.
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.

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

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.

Data safety

• The NAP is structured around five sub-committees dedicated to raising awareness, monitoring resistance patterns, strengthening infection control, optimizing antibiotic use, and advancing research.
• 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 Nasser et al. (2021) reported that while people may possess some knowledge about antibiotics, they often exhibit negative attitudes toward their use .
• Pharmacists were the second-most common source, consulted by 9.4% (63 participants).
• Al-Shibani et al. (2017) found that self-medication with antibiotics, even for minor illnesses like sore throats, is common in Riyadh .

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.
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.
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.
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.

3.4. Data Presentation and Analysis

This study aimed to assess knowledge, attitudes, and practices toward AR among non-medical university students in Riyadh, Saudi Arabia, and to identify factors influencing https://www.betsomnia-nl.nl/ antibiotic use. Including non-medical university students in this study is critical due to their heightened risk of antibiotic misuse, lack of formal medical training to guide appropriate use, and potential influence on public health behaviors. 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.

Among Staphylococcus aureus isolates, 32% were methicillin-resistant (MRSA), while Streptococcus pneumoniae demonstrated penicillin G resistance (33%) and erythromycin resistance (26%) .

2. Knowledge, Attitude, and Practice of Antibiotic Resistance

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.
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.
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.
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).

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.

• Results Out of the 233 participants, 58.8% were female and 95.7% aged 18–24 years.
• While overall awareness and behavior appear positive, nearly four in ten students lack proper understanding and engagement in AR practices.
• 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.
• 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.
• This study adhered to strict ethical guidelines.
• Association between sociodemographic characteristics and sufficient knowledge, attitude, and practice of antibiotics among university students.

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.

• This study reveals a significant lack of knowledge and understanding about AR among non-medical university students.
• 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.
• Among Staphylococcus aureus isolates, 32% were methicillin-resistant (MRSA), while Streptococcus pneumoniae demonstrated penicillin G resistance (33%) and erythromycin resistance (26%) .
• Antimicrobial resistance (AMR) poses an urgent global health crisis, contributing to approximately 700,000 deaths worldwide annually.
• 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.
• Abstract Introduction Antibiotic misuse is a growing global concern as it exacerbates antimicrobial resistance (AMR) and in Ghana, antibiotic misuse persists.

Published in Discover Public Health

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.
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.
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 .
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 https://www.betsomnia-nl.nl/ Out of the 233 participants, 58.8% were female and 95.7% aged 18–24 years.

3.2. Data Collection Instrument

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.

3.4. Data Presentation and Analysis

This study aimed to assess knowledge, attitudes, and practices toward AR among non-medical university students in Riyadh, Saudi Arabia, and to identify factors influencing antibiotic use. Including non-medical university students in this study is critical due to their heightened risk of antibiotic misuse, lack of formal medical training to guide appropriate use, and potential influence on public health behaviors. 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.

Data safety

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.

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.

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.
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.
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.
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.

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• If you’re a current student who transitioned from the University of Adelaide or UniSA, check your email or visit the Adelaide University website for the latest transition updates.
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• The information on this website applies to services of the University of South Australia as of 19th December 2025 including for students completing their studies and graduating with UniSA during the period 19th December 2025 up until 31st March 2026.
• Each Academic Unit is focused on the quality of its teaching, research and the student experience, ensuring that UniSA students are equipped to meet the future needs of industry and society.

Student services

• THE Rankings demonstrate Unisa’s unceasingly enhanced academic agenda.
• Your feedback is vital for channelling new ideas into the experience we offer, both now and in the future.
• The information on this website applies to services of the University of South Australia as of 19th December 2025 including for students completing their studies and graduating with UniSA during the period 19th December 2025 up until 31st March 2026.
• Our diverse and welcoming community offers a variety of support services and activities including clubs, sports, events, leadership and volunteering opportunities, and more.
• Campus Central is your one-stop centre for student services and matters of student administration.
• Each Academic Unit is focused on the quality of its teaching, research and the student experience, ensuring that UniSA students are equipped to meet the future needs of industry and society.

Each Academic Unit is focused on the quality of its teaching, research and the student experience, ensuring that UniSA students are equipped to meet the future needs of industry and society. The information on this website applies to services of the University of South Australia as of 19th December 2025 including for students completing their studies and graduating with UniSA during the period 19th December 2025 up until 31st March 2026. For all information related to the new Adelaide University — including study applications for 2026, details for commencing and current students, and Graduate Research — please visit adelaideuni.edu.au. Your feedback is vital for channelling new ideas into the experience we offer, both now and in the future. Campus Central is your one-stop centre for student services and matters of https://www.crazystarcasino.co.uk/ student administration.