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

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

• The focus on non-medical students addressed literature gaps, while standardized, WHO-aligned questions minimized variability and improved global comparability.
• Age significantly impacted antibiotic-related attitudes and practices among students.
• Family/siblings or friends provided information for 7.0% (47 participants), while social media was a source for 6.8% (46 participants).
• Such initiatives would bridge technical expertise with public health priorities, positioning engineers as advocates for antibiotic stewardship.
• Targeted education is crucial to improve antibiotic awareness, especially among specific demographics.

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.
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.

Data Availability Statement

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.

3.4. Data Presentation and Analysis

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.

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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.
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.
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.

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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.
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.

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.

• The findings also reveal critical gaps in knowledge, attitudes, and practices among such students regarding antibiotic use.
• Understanding public knowledge, attitudes, and practices regarding antibiotics is essential for developing effective strategies to combat AR .
• 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.
• Amoxicillin was the most commonly reported antibiotic (65.7%).
• 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%).
• Similarly, Mostafa et al. (2021) found that Egyptian university students demonstrated low health literacy and limited knowledge about antibiotics, increasing the likelihood of misuse .
• This study provides vital data for public health initiatives and informs effective strategies to promote responsible antibiotic use.

Data safety

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 .
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.
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.