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.

• Further investigation into this demographic is essential for promoting responsible antibiotic stewardship and mitigating resistance on university campuses and beyond.
• Similarly, Mostafa et al. (2021) found that Egyptian university students demonstrated low health literacy and limited knowledge about antibiotics, increasing the likelihood of misuse .
• Antimicrobial resistance (AMR) poses an urgent global health crisis, contributing to approximately 700,000 deaths worldwide annually.
• Amoxicillin was the most commonly reported antibiotic (65.7%).
• Public health campaigns should prioritize the 17–24 age group, as university students represent a pivotal demographic shaping health behaviors, yet are often excluded from antibiotic stewardship initiatives.

3.4. Data Presentation and Analysis

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.

2. Study Design and Settings

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.

3. Sample Size

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 https://www.betsomnia-nl.nl/ of Saudi nationality (94.5%). All the questionnaires were reviewed before entering the data into the analysis program.
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 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 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.
• 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.
• 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.
• 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.
• The attitude section had a possible score range of 12–60, while the practice section ranged from 18–90.

Data Availability Statement

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.
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.

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 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 .

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.
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.
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.