Knowledge, Attitudes, and Practices Regarding Antibiotic Use and Resistance Among Medical Students in Pakistan: A Cross-Sectional Study

Vollständiger Abstract

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Background: Antibiotic resistance is a major global public health challenge, fueled in part by the inappropriate use of antibiotics among healthcare professionals and medical students. As future prescribers, medical students constitute a key target for educational interventions because their knowledge, attitudes, and prescribing practices are developed during undergraduate medical education. Objectives: To evaluate the knowledge, attitudes, and practices (KAP) related to antibiotic use and antimicrobial resistance among medical students from two medical institutions in Pakistan, and to investigate the relationship between KAP domains and selected sociodemographic characteristics. Methods: A cross-sectional survey was conducted among 324 medical students recruited via simple random sampling from Nawaz Sharif Medical College (NSMC) and Foundation University Medical College (FUMC). A validated self-administered questionnaire with Cronbach’s α = 0.84 assessed knowledge (3 items, maximum score 3), attitudes (5 items, maximum score 5), and practices (5 items, maximum score 5). Non-parametric tests (Mann–Whitney U, Kruskal–Wallis H, Spearman’s rho) and Chi-square analyses were performed using IBM SPSS Statistics version 21. Results: The mean knowledge score was 1.75±0.78 out of 3. Moderate knowledge was exhibited by 55.6% of students. Mean attitude and practice scores were 3.83 ± 1.08 and 2.71 ± 1.54 out of 5, respectively. The female students had significantly higher attitude scores than the male students (U = 11,086.50, p =.048). All three KAP domains varied significantly across academic years (p < .01). A significant moderate positive correlation existed between knowledge and attitude scores (ρ = 0.341, p < .001), but neither correlated significantly with practice. Self-medication was reported by 45.4% of participants and was significantly associated with year of study (χ² = 15.467, p = .004). Conclusion: Medical students demonstrated moderate knowledge and relatively favourable attitudes toward antibiotic stewardship but suboptimal practices, highlighting a KAP gap. Targeted educational interventions, formal stewardship training, and institutional policy reform are urgently required.