Antimicrobial resistance-related knowledge and practices among biology and pharmacy students: a questionnaire-based, single-centre, cross-sectional study applying the Special Eurobarometer 478 methodology

Introduction: Inappropriate use of antibiotics is one of the main drivers of antimicrobial resistance (AMR). The „Competency Framework for Education and Training on AMR for Health Workers” (WHO, 2018) defines the knowledge, attitudes, and practices required throughout the various domains of healthcare—including direct patient care, pharmaceutical services, laboratory diagnostics, and health management—to effectively reduce AMR-related burden.

Methods: A quantitative, single-center cross-sectional study was performed with purposive sampling among undergraduate biology and pharmacy students between 01/03/2021 and 01/02/2022. Data collection on AMR-related knowledge and practices was carried out using a 70-item, self-administered, online questionnaire based on the methodology of the Special Eurobarometer (EBM) 478 survey (European Commission, 2018). In addition, participants’ ability to recognize AMR-related terms and to identify pharmaceuticals (as antibiotic vs. non-antibiotic) was also assessed. Statistical analyses (descriptive statistics, Welch’s t-tests, and Pearson correlation) were performed using IBM SPSS 22.0. The study followed the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines.

Results: Among participants (N=388), 20.4% reported antibiotic use in the past 12 months; 90.7% obtained antibiotics via medical prescription, of which only 18.8% were preceded by sampling or microbiological tests. Frequently reported indications for antibiotic use were sore throat (37.9%), cough (21.9%), and fever (21.6%). No relevant associations were identified between AMR-related knowledge and gender, academic performance, or type of study (p > 0.05). Strong, positive correlations were shown among AMR-related knowledge scores, the number of correctly recognized AMR-related terms, and the number of correctly identified pharmaceutical agents (r=0.644 and r=0.518, respectively; p<0.001).

Conclusions: Graduate biologists and pharmacists possess specialized competencies that are essential for mitigating AMR. Similarly to recent, population-based EBM surveys, our sample frequently reported antibiotic use for indications suggestive of antibiotic consumption in inappropriate indications. Our findings highlight the need for continuous evaluation and targeted strengthening of AMR-related content within undergraduate curricula.