Association between Awareness on Antibiotic Resistance and Antibiotic Misuse Among Saudi University Students

Background: Saudi Arabia has the highest prevalence of resistant pathogens in the Gulf Region, with a rapid increase in antibiotic resistance seen in recent years. Misuse is common despite laws prohibiting dispensing antibiotics without prescription. This study was conducted to determine the association between awareness of antibiotic resistance and antibiotic misuse among Saudi university students. Specifically, it aimed to determine the proportion of university students who were aware of antibiotic resistance, the proportion of university students who were aware that antibiotic resistance is a public health problem, the prevalence of antibiotic misuse among university students, and the association between awareness and antibiotic misuse. Methods: The study utilized an analytic cross-sectional design. By using a self-administrated survey, responses on awareness of antibiotic resistance as well as antibiotic use among bachelor students were obtained. Two-stage stratified cluster sampling was conducted to select the required 825 participants. Epi Info® version 7 was used to estimate the proportion of students who were aware of antibiotic resistance as well as the proportion of students who misused antibiotics. Logistic regression was used to determine the association between awareness of antibiotic resistance and antibiotic use. Results: Over 75% of university students were aware of antibiotic resistance (95% CI: 72.09% - 77.98%), while 54.67% (95% CI: 51.26% - 58.03%) were aware that antibiotic resistance is a public health problem. Nearly 67% misused antibiotics (95% CI: 63.63% - 70.04%) with failure to follow the prescribed number of days of antibiotic therapy and using leftover antibiotics as the most common forms of misuse. Students who were aware of antibiotic resistance were 27.96% less likely to misuse antibiotics (OR = 0.7204, p = 0.0642). Those who were aware that antibiotic resistance is a public health problem were 51.32% less likely to misuse antibiotics (OR = 0.4868, p < 0.0001). Conclusion: Awareness of antibiotic resistance is associated with lower antibiotic misuse. Education campaigns on the consequences of inappropriate antibiotic use and the development of antibiotic resistance should be intensified.