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

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.

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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.
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.

  • 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.
  • 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%).
  • 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.
  • Our study revealed a lack of knowledge regarding the safe use of antibiotics and inadequate medical practices related to their consumption among the population.
  • Age is one factor linked to less responsible antibiotic behaviors, suggesting certain groups are more prone to misuse.

Data Availability Statement

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 https://www.betsomnia-nl.nl/ 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 .
Among Staphylococcus aureus isolates, 32% were methicillin-resistant (MRSA), while Streptococcus pneumoniae demonstrated penicillin G resistance (33%) and erythromycin resistance (26%) .
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.
This section collects any data citations, data availability statements, or supplementary materials included in this article. (Abdulmohsen Alhussain) analyzed the data and concluded. (Abdulmohsen Alhussain)) contributed to gathering and organizing the data.
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.

Data safety

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).

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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.

  • Policymakers must implement multifaceted interventions addressing healthcare and patient factors.
  • 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.
  • This course could cover resistance mechanisms, global antimicrobial resistance (AMR) trends, and ethical considerations in engineering contexts (e.g., pharmaceutical waste management).
  • These elements collectively strengthen insights into antibiotic awareness in an understudied demographic.
  • 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.

2. Knowledge, Attitude, and Practice of Antibiotic Resistance

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.

3.2. Data Collection Instrument

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.
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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