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

• 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 .
• Pharmacists were the second-most common source, consulted by 9.4% (63 participants).
• 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 .
• 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 .

2. Study Design and Settings

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.

Links to NCBI Databases

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.

• For example, while many refrain from sharing leftover antibiotics—considered a positive behavior—negative attitudes toward antibiotic use persist.
• 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.
• 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.
• The study converted all antibiotic-related knowledge, attitude, and practice scores into percentages to standardize scoring and classify proficiency levels.
• 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.
• 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 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.

2. Study Design and Settings

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 .

2. Knowledge, Attitude, and Practice of Antibiotic Resistance

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

3. Sample Size

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.
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.
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).
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.

3.2. Data Collection Instrument

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.
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). Verbal informed consent was obtained from all participants, detailing the study’s purpose, procedures, risks, and benefits. These deficiencies in health literacy and antibiotic education underscore the urgent need for targeted educational interventions .
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.