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.

2. Knowledge, Attitude, and Practice of Antibiotic Resistance

  • The sample was then proportionally allocated to each university.
  • 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.
  • In our Riyadh-based sample, participants were predominantly Saudi nationals, reflecting the local university demographics.
  • 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.
  • Using simple random sampling, 233 students were enrolled across five health programs.

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.
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. 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. 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. However, due to limited antibiotic education, non-medical students frequently misuse antibiotics—taking them without prescriptions, using leftover medication, sharing antibiotics, or discontinuing treatment early. For example, while many refrain from sharing leftover antibiotics—considered a positive behavior—negative attitudes toward antibiotic use persist.

2. Study Design and Settings

  • A national study on Gram-positive bacteria in Saudi Arabia revealed alarming resistance trends.
  • 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.
  • Logistic regression model was computed to identify predictors of inadequate knowledge, negative attitude, and poor practices towards antibiotics 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.
  • Sources of information about the participants’ antibiotic use.
  • (Abdulmohsen Alhussain) analyzed the data and concluded.

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.
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.
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.
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.

Data Availability Statement

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 safety