As an integral and educated segment of society, students influence public health behaviors and community practices. A literature review identified only three studies on antibiotic KAP among healthcare students 9,10,11, with no published research on non-medical university students in Saudi Arabia 28,29,30. 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. Risky behaviors—such as self-medication and sharing antibiotics without prescriptions—were widespread, revealing a mismatch between partial awareness and actual practices 13,45,46,47,48,49.

Data safety

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.

3. Sample Size

Students may lack awareness of pharmacists’ expertise, highlighting an opportunity to diversify accessible, trusted healthcare sources for public education. However, expanding awareness to include pharmacists—equally qualified to educate on antibiotic use and resistance—is critical. Such contradiction is probably due to the inclusion in their sample with all age groups rather than a young population of university students . As depicted in Table 1, among the 672 participants involved in this study, the mean age of the students was 20.2 years ±standard deviation (SD) 1.8.

• Students from literary fields were the most likely to have insufficient knowledge, attitudes, and practices, while those in science and engineering showed better outcomes.
• This scoring framework ensured consistency in evaluating participants’ antibiotic-related attitudes and practices, aligning with established methodologies to enhance reliability and comparability of results.
• Recent studies indicate that many individuals lack adequate knowledge about proper antibiotic use, contributing to the spread of resistance.
• 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.
• Additionally, many individuals discontinue antibiotics as soon as they feel better rather than completing the full course, further exacerbating AR risks.
• While our study primarily focused on university students within Riyadh, we acknowledge that nationality could indeed play a role.

2. Study Design and Settings

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.
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.
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 https://www.betsomnia-nl.nl/ antibiotics was healthcare professionals, particularly doctors.
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.

Associated Data

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.

• Collectively, the findings emphasize the need for targeted educational campaigns to improve antibiotic stewardship, addressing misconceptions and promoting responsible use within this population.
• 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 .
• 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).
• Risky behaviors—such as self-medication and sharing antibiotics without prescriptions—were widespread, revealing a mismatch between partial awareness and actual practices 13,45,46,47,48,49.
• 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 .
• Combining prevention and response interventions is essential for effective control in healthcare settings .

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.

Data Availability Statement

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.

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.
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.