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.

• Notably, students aged 19–20 demonstrated the highest rates of insufficient knowledge and unsafe behaviors compared to other age groups.
• 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.
• The results advocate for tailored educational programs to enhance antibiotic awareness, particularly in demographics where age, gender, and academic discipline significantly influence outcomes.
• This study aims to assess the level of awareness about AR.
• 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.

Among Staphylococcus aureus isolates, 32% were https://www.betsomnia-nl.nl/ methicillin-resistant (MRSA), while Streptococcus pneumoniae demonstrated penicillin G resistance (33%) and erythromycin resistance (26%) .
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.
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 Availability Statement

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.
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

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).
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.

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

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.

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.

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.
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 .
The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. Targeted education is crucial to improve antibiotic awareness, especially among specific demographics. First, the reliance on self-reported data introduces risks of recall bias (e.g., inaccuracies in recalling past antibiotic use) and social desirability bias (over reporting adherence to guidelines), potentially compromising the validity of responses. These elements collectively strengthen insights into antibiotic awareness in an understudied demographic. Key strengths include a robust, gender-balanced sample of non-medical Riyadh students, enhancing statistical power and representativeness. The results advocate for tailored educational programs to enhance antibiotic awareness, particularly in demographics where age, gender, and academic discipline significantly influence outcomes.

2. Study Design and Settings

• Using simple random sampling, 233 students were enrolled across five health programs.
• 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.
• In our Riyadh-based sample, participants were predominantly Saudi nationals, reflecting the local university demographics.
• Although the dataset contained minimal missing values, specifically about ten instances within the attitude assessment, mean imputation was employed to address these gaps.
• 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.
• 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.
• The sample was then proportionally allocated to each university.

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.
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.