Knowledge, attitude and practice of antibiotic use and misuse among adults in Riyadh, Saudi Arabia

Awareness of Antibiotic Misuse in Upper Respiratory Tract Infections Among Adults in the Bisha Governorate in 2024

INTRODUCTION

Antibiotics are targeted to kill or inhibit the growth of bacteria and have no effect on viral agents. Unfortunately, viruses cause about 80% of respiratory tract infections, and up to 75% of antibiotics are prescribed for URTIs. Overuse of antibiotics is linked to a number of issues, including the emergence of antibacterial resistance, an increase in the prevalence of chronic illnesses, a rise in the expense of healthcare services, and the emergence of side effects. This study aimed to assess the awareness of antibiotic misuse for URTIs among adults in the Bisha governorate in 2024.

METHODS AND MATERIALS

A community-based, cross-sectional study was conducted in the Bisha governorate among the adult population. Data was collected using an online standardized self-administered adapted questionnaire. The questions vary from multiple choice to Likert scale questions, and each question has 2 points. Data was analyzed using SPSS version 26 (IBM SPSS Statistics, Armonk, NY).

RESULTS

The response rate was about 85.3% (721/845). The ages of the participants ranged between 18 and 75 years. There were 360 (49.9%) male respondents and 361 (50.1%) female respondents. The study revealed that 83.1% (599) of the participants have poor awareness of antibiotic misuse in URTIs. Knowledge of antibiotic misuse consequences was poor at 66.7% (481). There was a significant difference observed between the residents of Bisha city compared to the residents of Bisha villages in total knowledge level about antibiotic misuse in URTIs (p = 0.030).

CONCLUSION AND RECOMMENDATIONS

The population of the Bisha governorate has a poor knowledge of antibiotic misuse in URTIs. Therefore, efforts should be made to increase the knowledge and awareness of the general public about the problem.

Knowledge, Attitude, and Practice of Antibiotic Resistance Among General Population in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Antibiotic resistance is a global public health concern, and understanding the knowledge, attitudes, and practices (KAP) of the general population is essential for effective prevention and management. This cross-sectional study aimed to assess the KAP of antibiotic resistance among adults in Saudi Arabia.

MATERIALS AND METHODS

Between August 2023 and October 2023, 1000 participants aged 16-65 years from various regions in Saudi Arabia were surveyed using an online questionnaire. Data were analyzed using Excel and IBM SPSS Statistics version 27.0.0 (Armonk, NY: IBM Corp.). The sociodemographic characteristics of the participants were examined, and KAP variables towards antibiotic resistance were explored through a range of statistical methods, including frequencies, percentages, means, and standard deviations. Significance was defined as a p-value of ≤0.05.

RESULTS

The majority of participants were Saudi natives (98.1%) with ages between 16 and 25 years (38%), and over half were female (55.7%). More than half held a university degree (54.7%), mainly in non-medical fields (73.3%), and a significant portion reported a monthly income above 10,000 Saudi Riyals (49.7%). Regarding knowledge, 76.5% were aware of antibiotic resistance, but only 24.2% correctly identified its causes. Attitude assessments showed that 50.8% never used antibiotics as a preventive measure, and 47.3% always followed medical prescriptions. Practices revealed that 50.5% rarely used antibiotics, and 68.8% obtained antibiotic prescriptions from doctors. Additionally, 68.9% stopped taking antibiotics only after completing the course.

CONCLUSION

It is important to implement health education campaigns aimed at the public, emphasize the role of health care providers in health education for the general public, and enforce stringent regulations to control the non-prescription dispensing of antibiotics. However, further studies are needed on this subject in the future.

Risk factors in acquiring multidrug-resistant Klebsiella pneumoniae infections in a hospital setting in Saudi Arabia

Over the last decades, the prevalence of multidrug-resistant (MDR) Klebsiella pneumoniae in clinical settings has increased progressively. This study determined the prevalence and risk factors associated with MDR K. pneumoniae infection among hospitalized patients in a referral hospital located in southern Saudi Arabia. A prospective cross-sectional study was conducted in King Abdullah Hospital from April 2021 to March 2022. K. pneumoniae (n = 211) bacteria were recovered from clinical samples of adult patients and examined for antibiotic susceptibility. Univariate and multivariate logistic regressions were applied to determine the factors associated with MDR K. pneumoniae infection. MDR K. pneumoniae strains was found in 66.8% (142/211) of the patients. Among MDR K. pneumoniae, the highest resistance rate was determined for ampicillin (100%), cefuroxime (97.9%), ceftriaxone (94.3%), and aztreonam (92.2%). The lowest resistance rate was determined for colistin (16.3%), and tigecycline (6.4%). Further, the patients' gender, age group, intensive care unit (ICU) admission, invasive medical devices, and chronic illness were found to be significantly associated with MDR K. pneumoniae infection. The independent risk factors associated with MDR K. pneumoniae infection were the male gender (adjusted odds ratio [AOR] 2.107, 95% confidence interval CI 1.125‒3.945, p = 0.02), patients ≥ 65 years of age (AOR 1.905; CI 1.003‒3.616, p = 0.049), ICU admission (AOR 1.963; CI 1.033‒3.732, p = 0.04), diabetes (AOR 1.95; CI 1.02‒3.727, p = 0.043) and chronic obstructive pulmonary disease (AOR 7.172; CI 1.557‒33.032, p = 0.011). The study offered a vision of MDR K. pneumoniae infection in our setting and provided essential indications for further studies that may lead to the prevention and reduction of MDR bacteria.

Knowledge, Attitude, and Practice of using Antibiotics among the Community in Eastern Province, Saudi Arabia

Objectives

The purpose of this study is to explore and evaluate the knowledge, attitude, and practice of using antibiotics among the community in the Eastern Province, of Saudi Arabia.

Methods

A cross-sectional study was conducted, from February 2022 through March 2022, among people in Eastern Province, Saudi Arabia.

Results

The study population was 753 of the Saudi community. The questionnaire used open-ended and multiple-choice questions. Out of 753 participants, only 254 (55.6%) think that antibiotics can treat a bacterial infection, whereas 163 (35.7%) and 82 (17.9%) think it treats viral and fungal infections respectively. 26 (5.7%) of the respondents think that they should be stopped when the antibiotics are finished, while 72 (15.8%) think that they should be stopped when the symptoms disappear. The most common side effect in the respondent's opinion was diarrhea 183 (40%), followed by 168 (36.76%) antibiotics resistance. The major reason for taking antibiotics without a prescription was found to be mild symptoms 28 (50.90%), adequate information 21 (38.18%), difficulty in taking appointments 17 (30.90%), long waiting hours during the hospital visits 15 (27.27%). 169 (36.9%) kept the leftover antibiotics for reuse. The most common antibiotics used for self-medication were found to be Amoxicillin and clavulanic acid 23 (41.8%), followed by Amoxicillin 9 (16.36%). Knowledge of antibiotic resistance was highest in the age group 20-30 (62.7%) (P < 0.05).

Conclusion

People in Saudi Arabia show a high awareness of antibiotics' proper usage, and this returns to the great awareness campaign held by The Ministry of Health (MoH).

Awareness and Knowledge of Antibiotic Resistance and Risks of Self-Medication With Antibiotics Among the Aseer Region Population, Saudi Arabia, 2023

BACKGROUND

Antibiotics are a groundbreaking discovery that revolutionized the treatment of infectious diseases in both humans and animals during the 20th century. However, their overuse and misuse led to serious public health threats, causing widespread concern and significant social and economic consequences. Microorganisms have a natural ability to develop resistance to antibiotics over time through genetic mechanisms, which has further exacerbated the problem. Unfortunately, in the last two decades, there has been a dearth of new antibacterial substances discovered, which has only worsened the situation.

AIM

This study aims to assess the awareness and knowledge of antibiotic resistance and risks of self-medication with antibiotics among the Aseer region population, Saudi Arabia 2023.

METHODS

An observational cross-sectional survey was conducted in Saudi Arabia targeting persons aged 18 to 80 years old living in the Aseer region, Southern of Saudi Arabia. The data were collected using a pre-structured questionnaire after an intensive literature review and expert's consultation. The questionnaire was distributed throughout the social medial channels. The study questionnaire was uploaded online till no more new cases participated and no new answers were obtained.  Results: A total of 300 participants completed the study questionnaire. Participants' ages ranged from 18 to 80 years with a mean age of 31.5 ± 12.9 years old. Exactly 200 participants (66.7%) were females. As for the educational level, 209 (69.7%) had a university level of education. Two-hundred and three (67.7%) participants had an overall poor knowledge and awareness about antibiotic resistance and risks of self-medication. Also, 103 (34.3%) participants used antibiotics without prescription before and 100 (33.3%) used leftover antibiotics from a previous infection.

CONCLUSION

In conclusion, the current study showed that nearly one out of three participants in the Aseer region had unprescribed antibiotics. Another unsafe practice was that the same percent used leftover antibiotics from a previous infection. As for participants' knowledge of antibiotic resistance, also one-third of the respondents had good knowledge about the issue.

Physician's Knowledge and Attitudes on Antibiotic Prescribing and Resistance: A Cross-Sectional Study from Hail Region of Saudi Arabia

BACKGROUND

Antibiotic (AB) resistance is caused partly by overuse, varies by region, and is influenced by prescriber perspectives. This study sought to determine physicians' knowledge and attitudes toward AB prescribing, particularly in the Hail region of Saudi Arabia.

METHODS

An interdisciplinary team created and validated an electronic questionnaire via the test-retest method that measured reliability and consistency. The 19 questions covered the following subjects: demographic information (7), experience with AB resistance in daily work (3), AB prescribing behavior (2), communication with patients regarding AB resistance (3), and prescribing practices (4). The revised questionnaire was prepared and distributed to physicians in the Hail region via multiple electronic communication channels. Inferences were drawn based on descriptive statistics and multivariate regression analysis.

RESULTS

The questionnaire responses of 202 participants were eligible for analysis. A total of 70 (34.80%) participants were general practitioners, 78 (38.12%) were engaged in daily work that was only mildly related to AB resistance, and 25 (12.37%) performed work that was substantially related to AB resistance. A total of 88 (43.56%) physicians believed that prescribing behavior contributed to the emergence of AB resistance, whereas 68 (33.66%) did not. Regarding exposure, 51 (25.24%) physicians reported encountering instances of AB resistance monthly, whereas 104 (51.48%) reported seeing cases of AB resistance very rarely. In terms of prescribing practices, 99 (49.0%) physicians prescribed ABs to patients daily and 73 (36.13%) weekly. Regarding AB-resistance-related communication with patients, 73 (36.13%) physicians frequently discussed AB resistance with patients suffering from infections, whereas 13 (6.4%) never discussed it with patients.

CONCLUSION

General practitioners in the Hail region exhibited comprehensive awareness of the elements that contribute to AB resistance but only rarely communicated about the issue with their patients, presuming the latter to be oblivious to the science behind AB resistance. Our findings suggest that the features underlying practitioners' AB prescribing behavior could be a powerful strategy for lowering AB resistance.

Knowledge, Attitudes, and Practices among Pharmacy and Non-Pharmacy Interns in Saudi Arabia Regarding Antibiotic Use and Antibiotic Resistance: A Cross-Sectional Descriptive Study

This cross-sectional descriptive study aims to explore the knowledge, attitudes, and practices among pharmacy, dentistry, medicine, and nursing interns in Saudi Arabia regarding antibiotic use and antibiotic resistance. Interns received a soft copy of a structured and validated self-administered questionnaire using an online survey platform. A total of 266 interns responded to the questionnaire. On average, the participants achieved good scores in the knowledge and practice domains, followed by the attitude domain. The average knowledge percentage was 76.1% (SD 17.1) compared to 84.6% (SD 20.5) for practices and 61.5% (SD 23.2) for attitudes. The results suggest that pharmacy interns had insignificantly better overall scores compared to non-pharmacy interns for knowledge, attitudes, and practices. This study shows that the scores for knowledge, attitudes, and practices of pharmacy, dentistry, medicine, and nursing interns regarding antibiotic use and resistance were high overall. However, interns' belief in their responsibility in preventing antibiotic resistance is lacking.

Assessment of knowledge, attitude, and practice of antibiotics prescription among healthcare residents at King Abdulaziz medical City, Jeddah, Saudi Arabia

Introduction

Antibiotic resistance (ABR) is defined as bacteria's resistance to therapy despite therapeutic levels of antibiotics. It is a global health concern. Data on the antibiotic prescription practice of physicians, in general, are limited in Saudi Arabia. Therefore, we aim to assess the knowledge, attitude, and practice of antibiotic prescription between surgical and non-surgical residents at King Abdulaziz Medical City (KAMC).

Methods

A cross-sectional study was conducted at KAMC in Jeddah, Saudi Arabia, from September 2019, until March 2020. The questionnaire contained demographic information and 31 questions based on the studied variables: knowledge (17), attitude (4), and practice (10).

Results

The response rate was 83 %. Male to female response rates were 54 % and 46 %, respectively. The majority of respondents (72 %) were non-surgical residents. Positive practice skills showed that 55 % of all healthcare residents always used practice guidelines for antibiotic prescription in their daily work (P-value < 0.001). Most residents (50 %) sometimes used delayed prescriptions. Non-surgical residents discussed ABR with patients more than surgical residents (P-value = 0.028). Lack of patient interest was the common cause for not discussing ABR with patients (42 %). Non-surgical residents had significantly more training on antibiotic prescription (p-value = 0.001). The fear of infection spread due to not prescribing an antibiotic was significantly higher in non-surgical residents (P-value < 0.001). Non-surgical residents (76 %) took a past medical history of antibiotic consumption more than surgical residents (24 %) (P-value = 0.003). Antibiotic prescription for residents was not influenced by advertisements (91 %). The most common resistant organisms reported by residents were insignificant between the two groups. The results also showed that the residents' common choice of antibiotics was not statistically different between surgical and non-surgical residents in most antibiotic classes.

Conclusions

We found that practice guidelines, formal training, and taking patients' past medical histories were significantly higher among non-surgical residents. In contrast, surgical residents were prescribing more antibiotics due to the fear of the spread of the infection. Proper training is essential for all healthcare residents to overcome differences among different specialties.

Antibiotic Use among Patients Visiting Primary Hospitals in Northwest Ethiopia: A Multicenter Cross-Sectional Survey

Background. Antimicrobial medications are becoming ineffective because of the surge in antimicrobial resistance. Poor knowledge and inappropriate beliefs combined with the misuse of antibiotics may be common in the community and public health institutions. This study assessed the knowledge, belief, and antibiotic use practice among patients visiting rural hospitals in Northwest Ethiopia. Methods. A facility-based multicenter cross-sectional survey was conducted in Northwest Ethiopian primary hospitals from August to September 2020. The data are presented as frequencies and means (±SD) of our findings. The independent samples T test and One-Way Analysis of Variance (ANOVA) were used to explore the mean knowledge differences of antibiotic use among respondents. A $p$ value of <0.05 with 95% CI was considered significant. Results. More than half of the participants (57.2%) were males, and the mean age was 34.8 ± 13.4 years. The mean (±SD) knowledge score of the respondents was 3.69 (±1.7) (range: 0 to 10), and the majority (69.7%) had poor knowledge. The mean (±SD) belief score (acceptance towards antibiotic use) of the respondents was 20.08 ± 4 (range: 7 to 35) and most (70.1%) of the respondents had moderate levels of perception regarding antibiotic use. The majority (69.5%) of respondents took antibiotics over the past year. Participants practiced inappropriate uses of antibiotics such as medication discontinuation (49.5%), keeping unused antibiotics for future use (35.5%), and sharing medications with/from others (30.1%). Diploma holder participants had significantly higher mean knowledge scores on antibiotic use than those who were unable to read and write ( $p=0.047$ ). Similarly, students had higher mean knowledge scores compared with farmers ( $p=0.024$ ), merchants ( $p=0.031$ ), and housewives ( $p=0.047$ ). Conclusion. Our study showed a widespread misuse of antibiotics in Northwest Ethiopia. Malpractice such as dose interrupting, sharing of antibiotics for/from the others, and keeping leftover drugs for future use were common among the respondents. These findings suggest that a greater effort is required in public education related to proper and safe uses of antibiotics and that greater efforts are needed to enforce the control of antibiotic use to overcome the emergence of antibiotic resistance.

An Exploration of the Public’s Attitude toward Antibiotic Use and Prescription in Light of the Recent Ministry of Health Regulations: A Cross-Sectional Study in the Kingdom of Saudi Arabia

Background: Restricting antibiotic (AB) use with prescriptions and ensuring proper knowledge and attitudes toward AB use is important to reduce antibiotic resistance (ABR). To prevent resistanse problem, several countries have applied prescribing restrictions. Thus, the aim of this work was to re-evaluate the public knowledge and attitudes related to AB use in light of the recent Ministry of Health (MOH) restrictions on AB prescriptions. Methods: A cross-sectional, population-based survey was distributed through various social media platforms. The survey was distributed via email and personal social media. Data were collected and analyzed using appropriate statistical tests. Result: A total of 1333 participants completed the survey. Most participants were female (i.e., 70%), aged 18–24 years old (i.e., 40%), and were aware of the AB restrictions implemented by the MOH. In addition, 77% of participants were aware of the MOH Emergency Call Center (i.e., the 937 Service), but most did not know that it could be used to obtain an AB prescription. Conclusion: Although the knowledge and attitude of the general Saudi population appear better than before, it remains clear that some elements of the population’s knowledge, attitude, and practice need to be strengthened. This could be achieved by utilizing effective channels such as the MOH 937 Service and increased advertising.

Antibiotic Use and Resistance Knowledge: Awareness Among the General Public in Jazan, Saudi Arabia

Background and objective: Antibiotics (Abs) are a class of medication generally prescribed for bacterial infections. Abs misuse, caused by either medication non-compliance or self-medication, may lead to Abs resistance, a problem that is trending around the globe. In 2018, dispensing Abs without a prescription became prohibited in Saudi Arabia. This study aimed to evaluate knowledge and attitude toward Abs use and resistance in Jazan Province.

Materials and methods: A cross-sectional study was conducted in the population of Jazan, using a self-administered electronic questionnaire to assess the knowledge and attitude toward Abs use and resistance and its related factors.

Results: According to our findings, 543 participants responded and most of the participants use Abs with a prescription (n = 280; 75%). About 40% identified correctly that Abs can treat only bacteria, not viruses, and 44% denied that Abs can treat all coughs and common cases. Then, regarding the knowledge about resistance, we found that those who had heard about Abs resistance represented more than half of the participants (56%), and had better knowledge about Abs use. Further, more than half of those who have heard about Abs resistance correctly defined the antibiotic susceptibility test, and about two-thirds were able to answer the related questions about Abs resistance.

Conclusion: To conclude, a positive correlation was found between knowledge about Abs resistance and Abs use. Thus, national Abs regulations and policies with continuous education and awareness must be continued to ensure a better understanding of Abs use.

Assessment of Knowledge, Attitude, and Practice of Antibiotic Use among the Population of Boyolali, Indonesia: A Cross-Sectional Study

Misuse and overuse of antibiotics are potential causes of the increasing prevalence of antibiotic resistance (ABR). Having information about the knowledge, attitude, and practices concerning antibiotics use by the public might help control ABR growth. Therefore, this cross-sectional study aimed to investigate the levels and associated factors of knowledge, attitude, and practice (KAP) of antibiotics use among the public. A questionnaire was designed and validated, which consisted of a total of 51 questions with four sections: demographics (6), knowledge (20), attitude (12), and practice (13) to measure KAP. Univariate analysis (using Mann-Whitney U and Kruskal-Wallis analysis) was applied to assess the differences in the mean scores of KAP. Linear regression analysis was performed to identify factors associated with KAP. Finally, using Spearman analysis we have examined the correlation between responses to the KAP. The sample size of this study was 575, with a 99.96% response rate. Regarding knowledge, 73.12% of respondents stated that antibiotics could be used to treat viral infections, and 63.35% of respondents answered that antibiotics could reduce fever. Concerning attitude, 50% of respondents had considered stopping taking antibiotics as soon as symptoms had disappeared. In analyzing practice, we found 40% of respondents obtained antibiotics from a pharmacy without a prescription from a physician, a nurse, or a midwife. Statistical analysis revealed that KAP about antibiotic use was significantly associated with gender, area of residence, level of education, and monthly income (p < 0.05). Our findings concluded that men, respondents with low income, those with low-level education, and those living in rural areas are more prone to excessive use of antibiotics without knowing the adverse effects of improper use and how it can contribute to high ABR. So it is urgently necessary to strengthen policies on antibiotics use, including drug provision, distribution, and sales. In addition, people with low KAP should be a priority consideration in education outreach initiatives.

Public knowledge, attitude and practice towards antibiotics use and antimicrobial resistance in Saudi Arabia: A web-based cross-sectional survey

Background: Antimicrobial resistance is a global issue that causes significant morbidity and mortality. Therefore, this study aims to assess knowledge, attitudes, and practices (KAP) of the general Saudi populations toward antibiotics use.

Design and method: A cross-sectional, anonymous online survey was conducted from January 1 to May 11, 2020, across five major regions of Saudi Arabia. Participants (aged ≥18 years) were invited through social media to complete an online self-structured questionnaire. All data were analyzed by Statistical Package (SPSS v. 25). Descriptive statistics, Pearson’s Chi-squared, t-tests, one-way analysis of variance (ANOVA), and Pearson correlation analyses were conducted.

Results: Out of 443 participants, the majority (n=309, 69.8%) were females, 294 (64.4%) were married, 176 (39.7%) were 25-34 years of age, 338 (76.3%) were living in the Eastern Province, 313 (70.7%) had college or higher education, 139 (31.4%) were not working, and 163 (36.8%) had a monthly income of USD 800-1330. Overall, most participants demonstrated good knowledge and practice (88% and 85.6%, respectively). However, 76.8%had inadequate attitude score levels towards antibiotics use. Of all the respondents, 74.9% knew that not completing a full course of antibiotics may cause antibiotics resistance, 91.33% did not agree that antibiotics should be accessed without a prescription, and 94.04% will not hand over leftover antibiotics to family members. Factors associated with adequate knowledge were female, medical jobs, and higher income (p<0.05).

Conclusions: Our findings revealed that while most participants were aware of antibiotics use and demonstrated good knowledge, good practices, they had negative attitudes towards antibiotics use.

Antibiotic use in pregnancy: knowledge, attitudes and practices among pregnant women in Cape Town, South Africa

OBJECTIVES

To establish the knowledge, attitudes and practices (KAP) regarding antibiotic use and self-medication among pregnant women.

METHODS

We conducted a KAP survey of 301 pregnant women hospitalized at a tertiary hospital obstetric service in Cape Town, South Africa in November and December 2017, using an interviewer-administered 12 item questionnaire. We stratified analysis of attitudes and practices by participants' mean knowledge score (K-score) group (<6 versus ≥6 out of 7 questions). Multivariate models were built to identify independent predictors of antibiotic self-medication and K-score.

RESULTS

The mean age of pregnant women was 29 (SD 6.1) years, 44/247 (17.8%) were nulliparous, 69/247 (27.9%) were HIV-infected, 228/247 (92.3%) had completed secondary school and 78/247 (31.6%) reported a monthly household income in the lowest category of ≤50-100 US dollars (USD). The mean K-score was 6.1 (SD 1.02) out of 7 questions. Sixteen percent of the cohort reported antibiotic self-medication, with higher rates among pregnant women with K-score <6 [18/48 (37.5%) versus 32/253 (12.6%); P<0.001]. The monthly household income category of >500 USD (the highest category) was the only predictor of antibiotic self-medication behaviour [adjusted OR=6.4 (95% CI 1.2-35.2), P=0.03].

CONCLUSIONS

Higher antibiotic knowledge scores are associated with lower rates of antibiotic self-medication, whereas higher household income is correlated with increasing self-medication behaviours. Education of pregnant women regarding the potential dangers of antibiotic self-medication and stricter enforcement of existing South African antibiotic prescribing and dispensing regulations are needed.

Assessing the Effects of Basic Medical Science Courses on the Knowledge and Attitude towards Antibiotic Usage among Pre-Professional Students in Saudi Arabia

The curriculum of medical schools includes courses on antibiotics. Therefore, it is worth exploring information related to the knowledge and attitudes about antibiotics. In this cross-sectional study the questionnaire was administered to the undergraduates in two phases, before and after attending the basic medical science courses. The data were collected on demographic variables, source of antibiotics, level of knowledge, and changes in attitude statements. Data analysis was implemented using SPSS. The mean age of participants was 19.87 and 20.15 in phases I and II, respectively. Most of the participants’ parents had education at the university level and a monthly income above 15,000 SAR. Generally, students had good knowledge and attitude about antibiotics. A significant improvement in students’ knowledge in phase-II was noticed in “level of knowledge” (p-value = 0.044), “paracetamol is considered an antibiotic” (p-value < 0.001) and “overuse of antibiotics can cause antibiotics resistance” (p-value = 0.003). The overall knowledge and attitude of pre-professional students were good in both phases, but their attitude did not improve at a significant level in phase-II. There is a need to put more focus on antimicrobial therapy in their training.

Educational Video Improves Knowledge about Outpatients' Usage of Antibiotics in Two Public Hospitals in Indonesia

The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about "Responsible use of antibiotics" and "How to obtain antibiotics" is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients' knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test-post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents' knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous "yes" or "no" answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student's t-test was applied. The educational videos significantly improved outpatients' knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.

Knowledge, attitude, perception and practice of antibiotics usage among the pharmacy students

BACKGROUND

Resistance to antibiotics causes negative impact on health of the patients. Antibiotic resistance is the major global concern that has to be nullified for the better health outcome. The knowledge on antibiotics is very essential for the students who undertake pharmacy and health science courses. Hence a study was aimed to assess the level of knowledge, attitude, perception and practice on antibiotics usage among the pharmacy students of King Khalid University, KSA.

MATERIALS AND METHODS

A prospective online questionnaire based survey was carried out among the pharmacy students about knowledge, attitude perception and practice of antibiotics using 5-point "Likert scale" and true/false responses. The responses range from strongly agree to strongly disagree, and always to never were recorded. The data were analysed by using simple descriptive statistics.

RESULTS

Out of 300 students approached 212 responded and the response rate was found to be 71%. In this study, most (95%) of the students were aware of the emerging problem of antibiotic resistance due to inappropriate use of antibiotics. Majority (89%) of the students agreed the inappropriate use of antibiotics can increase the overall cost of treatment. However, over half of the (54%) students were not aware of the antibiotic resistance that may be a nation-wide problem of Kingdom of Saudi Arabia. The net positive response (NPR) and net other response (NOR) of all items in perception on antibiotics received more or less equal responses.

CONCLUSION

The knowledge of antibiotics usage among the students are considerably good compared with previous studies. However, the attitude, perception and practice on antibiotics usage among the pharmacy students are very poor. It alarms the need of appropriate education to enlighten antibiotic awareness for the better disease prevention and health outcomes for the benefit of patient community.

Pilot Survey of Knowledge, Attitudes and Perceptions of Hajj Deployed Health Care Workers on Antibiotics and Antibiotic Prescriptions for Upper Respiratory Tract Infections: Results from Two Hajj Seasons

Antimicrobial resistance (AMR) is a global public health issue. Upper respiratory tract infections (URTIs) are common illnesses during Hajj, for which antibiotics are often inappropriately prescribed. Hajj healthcare workers' (HCW) knowledge, attitudes and perceptions (KAP) about AMR and antibiotic use for URTIs are not known. We conducted a survey among HCWs during Hajj to explore their KAP regarding antibiotic use for URTIs in pilgrims. Electronic or paper-based surveys were distributed to HCWs during the Hajj in 2016 and 2017. A total of 85 respondents aged 25 to 63 (median 40) years completed the surveys. Most participants were male (78.8%) and were physicians by profession (95.3%). Around 85% and 19% of respondents claimed to have heard about AMR and antimicrobial stewardship programs, respectively, among whom most had obtained their knowledge during their qualification. Implementation of URTI treatment guidelines was very low. In conclusion, HCWs at Hajj have significant knowledge gaps regarding AMR, often do not use standard clinical criteria to diagnose URTIs and display a tendency to prescribe antibiotics for URTIs.

Knowledge and Attitude Towards Antibiotic Usage: A Questionnaire-Based Survey Among Pre-Professional Students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia

Introduction: Knowledge and attitudes towards proper antibiotic usage among students in medical and other health allied fields play a vital role in limiting the pandemic of antibiotic resistance. This study aimed to assess knowledge and attitudes toward antibiotic usage among pre-professional students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia. Methods: A self-administered cross-sectional survey of 347 first year students was conducted at the College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences using a validated questionnaire. Results: Nearly 63% of the students had a moderate level of knowledge. Two third of the students (69.7%) correctly knew that antibiotics are indicated for the treatment of bacterial infections. However, about 36% of the students incorrectly thought that antibiotics are also used to treat viral infections, while 28.5% were not sure. Only 38.8% of the students were aware of antibiotic resistance phenomena in relation to the overuse of antibiotics. Furthermore, only 27.3% correctly knew that penicillin is an antibiotic, and 74.4% were not sure if Paracetamol is an antibiotic. With regard to attitudes, 25.7% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 39.6% expected antibiotics to be prescribed for common cold symptoms. Conclusion: The students have misconception regarding antibiotic use indications. Therefore, awareness campaigns are needed to promote student's use of antibiotics in young generations particularly among the pre-professional health sciences students.