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.
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.

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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.

Data Availability Statement

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.
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.
Developed the overall framework and methodology for this study. Policymakers must implement multifaceted interventions addressing healthcare and patient factors. Second, the cross-sectional design precludes establishing causal relationships or analyzing temporal trends between awareness and behavioral factors. This course could cover resistance mechanisms, global antimicrobial resistance (AMR) trends, and ethical considerations in engineering contexts (e.g., pharmaceutical waste management). Younger students (19–20 years) emerged as a critical subgroup requiring early intervention during their formative academic years. Collectively, the findings emphasize the need for targeted educational campaigns to improve antibiotic stewardship, addressing misconceptions and promoting responsible use within this population.
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.
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.

Published in Discover Public Health

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.

Published in Discover Public Health

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.
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.

• Age significantly impacted antibiotic-related attitudes and practices among students.
• Such initiatives would bridge technical expertise with public health priorities, positioning engineers as advocates for antibiotic stewardship.
• The primary source of information on antibiotics was healthcare professionals, particularly doctors.
• A multistage sampling method was used, first stratifying Riyadh universities as public or private (three universities for each).
• Targeted education is crucial to improve antibiotic awareness, especially among specific demographics.
• Family/siblings or friends provided information for 7.0% (47 participants), while social media was a source for 6.8% (46 participants).

3.4. Data Presentation and Analysis

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.

• 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.
• This study aims to assess the level of awareness about AR.
• 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.
• 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.
• Level of knowledge, attitude, and practice toward AR among the university students.
• 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.
• Misconceptions persisted, with 13.3% believing antibiotics treat viral infections and 44.2% considering all antibiotics safe.

Combining prevention and response interventions is essential for effective control in healthcare settings . Family/siblings or friends https://www.betsomnia-nl.nl/ 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.