Does the problem begin at the beginning? Assessment of antimicrobial resistance-related knowledge, attitudes, and practices among health science students: a questionnaire-based, single-centre, cross-sectional study

Introduction: Perspectives and competencies developed during undergraduate health education critically influence antimicrobial resistance (AMR)-associated attitudes and future clinical decision-making in healthcare staff, particularly with regard to fostering patient safety and rational antimicrobial utilization. The aim of our study was to assess nursing and allied health science students’ knowledge, attitudes, and practices related to AMR.

Methods: A quantitative, single-centre cross-sectional study was performed with purposive sampling between 01/09/2021 and 20/09/2025. Data collection was carried out using an 83-item, self-administered online questionnaire consisting of the following domains: i) socio-demographic characteristics, ii) AMR-related knowledge, iii) attitudes towards AMR, iv) recognition of AMR-related terms, and v) practices related to antimicrobial consumption. Statistical analyses (descriptive statistics, Welch’s t-tests, binary logistic regression, and a 95% confidence interval [95%CI]) were performed using IBM SPSS 28.0. The study followed the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines.

Results: Among participants (N=312), 85.6% and 46.2% identified their formal health science training and the Internet as their main sources of AMR-related information, respectively. Participants enrolled in study programmes (e.g., nursing, dental hygiene) with stronger clinical and pharmacological components were more likely to possess adequate knowledge (OR=2.36; 95%CI: 1.49–3.71; p<0.001), hold positive attitudes (OR=2.19; 95%CI: 1.38–3.46; p<0.001), and recognize more AMR-related concepts (OR=2.95; 95%CI: 1.49–5.83; p=0.002). Overall, 51.3% demonstrated adequate knowledge, 59.3% had appropriate attitudes, while 15.4% correctly recognized a sufficient number of AMR-related concepts. In the past 12 months, 24.4% had used antibiotics (sources: medical prescription: 81.4%; leftover antibiotics: 6.7%; antibiotics from friends or family members: 7.4%), most commonly taking them to treat a throat ache (34.3%), fever (22.1%), or cough (18.9%).

Conclusions: Strengthening knowledge and attitudes toward AMR during undergraduate training is key to fostering evidence-based clinical decision-making in future practice. Continuous evaluation and enhancement of AMR-specific curricula should be considered ascore components of comprehensive AMR mitigation strategies.