Knowledge, Attitudes and Practices of Antibiotic Use Among Students in A Ghanaian Tertiary Institution

Knowledge, Attitudes and Practices of Antibiotic Use Among Students in A Ghanaian Tertiary Institution | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge, Attitudes and Practices of Antibiotic Use Among Students in A Ghanaian Tertiary Institution Kinako Denis Elia Dazangapai, Eric Darko, Michael Nkrumah-Appau, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7703640/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 19 Jan, 2026 Read the published version in Discover Public Health → Version 1 posted 15 You are reading this latest preprint version Abstract Introduction: Antibiotic misuse is a growing global concern as it exacerbates antimicrobial resistance (AMR) and in Ghana, antibiotic misuse persists. University students in the Allied Health Sciences are uniquely positioned to influence patterns of antibiotic use, both as practitioners and educators. The aim of this study was to investigate the knowledge and awareness of appropriate antibiotic use among university students. Methods A cross-sectional study was conducted among undergraduate students of the Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, from May–August 2024. Using simple random sampling, 233 students were enrolled across five health programs. Data on knowledge, attitudes, and practices (KAP) regarding antibiotic use were collected via a structured, pretested questionnaire. Scores were categorized using an 80% threshold. Logistic regression model was computed to identify predictors of inadequate knowledge, negative attitude, and poor practices towards antibiotics use. Results Out of the 233 participants, 58.8% were female and 95.7% aged 18–24 years. Overall, 77.3% demonstrated adequate knowledge, 67.4% positive attitudes, and 49.4% good practices toward antibiotic use. Misconceptions persisted, with 13.3% believing antibiotics treat viral infections and 44.2% considering all antibiotics safe. Academic level was the strongest independent predictor of knowledge; compared with level 100, students in higher levels had significantly reduced odds of inadequate knowledge ( p < 0.05). Positive attitude (aOR; 0.17) and female gender (aOR; 0.44) independently predicted good practices, while good practice (aOR; 0.17) strongly predicted negative attitudes ( p < 0.001) with reduced odds. Amoxicillin was the most commonly reported antibiotic (65.7%). Conclusion The study revealed that although most allied health sciences students possess some knowledge of appropriate antibiotic use, inappropriate practices such as self-medication and limited laboratory testing prior to antibiotic administration, persist. The findings also reveal critical gaps in knowledge, attitudes, and practices among such students regarding antibiotic use. Addressing these issues should be prioritized as an antimicrobial stewardship strategy as these students are crucial, tentative frontliners in healthcare administration in the country. antibiotics knowledge resistance attitude self-medication Figures Figure 1 Figure 2 INTRODUCTION The inappropriate use of antibiotics is a major contributor to antimicrobial resistance, a growing public health threat in low-and middle-income countries (LMICs). This resistance leads to treatment failures and increased morbidity and mortality (Ndaki et al., 2025 ). Antimicrobial resistance (AMR), driven especially by antibiotic misuse, threatens to undermine decades of advancements in healthcare. Education is a cornerstone in combating AMR, as evidenced by significant improvements in the understanding of antibiotic use and resistance (Sharma et al., 2024 ). Antibiotic misuse, as defined by the World Health Organization (WHO), encompasses various inappropriate practices related to antibiotics (WHO 2021). These include overuse, self-medication, and incomplete treatment. Such practices can lead to the emergence of antibiotic-resistant strains, posing a significant global health challenge (Sakeena et al., 2019 ). In 2019, the global burden of antimicrobial resistance (AMR) was estimated to be responsible for 4.95 million deaths (D’Arcy et al., 2021 ). Projections indicate that by 2050, this figure will escalate to 10 million deaths worldwide. Specifically, Africa and Asia are expected to bear the impact, accounting for 4.15 million and 4.73 million deaths, respectively. This continuous spread of AMR emphasizes the urgent need for comprehensive strategies to fight this critical health challenge (Appiah et al., 2021 ). Healthcare students are crucial stakeholders in combating AMR due to their future roles as care providers. Their knowledge and attitudes thus significantly influence the effectiveness of antimicrobial stewardship (AMS) programs (Sefah et al., 2022a ). Recent studies in LMICs, such as among college students in Eritrea show that over 65% of students self-medicated with antibiotics Gebregziabher (2024), while a study conducted among undergraduate medical students in Eastern Uganda reported a staggering 93.8% prevalence of self-medication of antibiotics, with common conditions such as diarrhea, peptic ulcers, and painful wounds being self-treated using antibiotics like amoxicillin and metronidazole (Nakato et al., 2023 ). However, on the other hand, most health students demonstrated good foundational knowledge of antibiotics' efficacy against bacterial infections and also acknowledged the menace of antibiotic misuse (Bonna et al., 2024 ). These studies highlight the gaps in knowledge and practice of proper AMS among allied health sciences students who are crucial stakeholders in the global fight against AMR. A testament to this is how in Ghana, some studies highlighted the critical gaps in knowledge about AMR among healthcare seekers. Importantly, exposure to tailored educational interventions at the point of care by allied health staff significantly improved participants' willingness to adopt AMR mitigation strategies (Otieku et al., 2023 ). Therefore, assessing and plucking knowledge gaps among allied health students, in the short and medium term will serve as a great resource in the fight against AMR as their optimum knowledge, attitudes and practice of good antimicrobial use will translate into their profession and practice (Kimbowa IM et al., 2024). Therefore, this study aimed to investigate knowledge, attitudes and practices of antibiotic use among students in a public university pursuing bachelor’s degrees in allied healthcare programs. MATERIALS AND METHODS Study design and site This employed a cross-sectional study to investigate the level of knowledge, attitude, and practices of appropriate antibiotics use among health students at the Faculty of Allied Health Sciences of the Kwame Nkrumah University of Science and Technology (KNUST) from May to August 2024. KNUST is the second largest university in Ghana located in Kumasi, the capital of The Ashanti region. It is organized into six colleges including Agriculture and Natural Resources, Art and Built Environment, Humanities and Social Sciences, Engineering, Health Sciences, and Science. Each college houses various faculties that offer degree programs across many academic disciplines, providing a comprehensive university experience. The Faculty of Allied Health Sciences, under the College of Health Sciences, has an estimated student population of approximately 2,000, drawn from various healthcare programs including Medical Laboratory Science, Nursing, Midwifery, Medical Imaging, and Physiotherapy. Study population, inclusion and exclusion criteria This study targeted undergraduate health science students aged ≥18 years, who were formally enrolled in Bachelor of Science degree programs in Medical Laboratory Science, Nursing, Midwifery, Medical Imaging, and Physiotherapy at the Faculty of Allied Health Sciences, KNUST. Eligibility criteria included active enrollment status and possession of a valid institutional student identification card bearing a unique identification number regardless of level of study, confirming their affiliation with the university. These criteria were established to ensure that participants were legitimate members of the university community and appropriately represented the target population for the study. Sample size estimation Sample size calculations using conservative assumptions ( p = 0.5, 95% confidence) and Cochran’s formula with finite population correction [ n=N*Z 2 *p(1-p)/e 2 (N-1) + Z 2 *p(1-p) ] indicated a target of approximately 323 participants for a ±5% margin of error and a population, N=2000. Recruitment constraints meant we enrolled n = 233 participants, with this, precision for proportion estimates was approximately ±6.00% (95% CI). Where appropriate, we presented adjusted estimates from regression models to align the sample with the target population. Ethical approval Ethical approval was obtained from the Committee on Human Research, Publications and Ethics (CHRPE/AP/207/24), at the Kwame Nkrumah University of Science and Technology, before commencing the study. Written informed consent was obtained from all participants prior to their involvement in the study. To ensure confidentiality and protect participants' identities, unique IDs were used in place of real names, thereby maintaining anonymity throughout the data collection and analysis processes. Data collection technique and tools A simple random sampling technique was used to sample health students from the Faculty of Allied Health Sciences at KNUST. In the application of the simple random sampling technique, students' identification numbers were utilized to ensure the accurate selection of participants and to prevent the inclusion of duplicate respondents. This approach facilitated the maintenance of sample integrity and minimized selection bias. Face-to-face interviews were conducted using a well-structured, closed-ended questionnaire to collect data on health students’ knowledge, attitudes, and practices regarding appropriate antibiotic use. The questionnaire was peer-reviewed and pilot tested before a final version was administered to participants. Participants were interviewed by the researchers and trained research assistants using the structured questionnaire. The first section of the questionnaire constituted the respondents’ demographic characteristics whilst the remaining sections were designed based on the study’s specific objectives. Assessment of Knowledge, Attitudes, and Practices (KAP) To evaluate the level of knowledge, attitudes, and practices (KAP) regarding appropriate antibiotics use among the health students, a structured questionnaire consisting of 16 scoring items was administered. The questionnaire included 7 items assessing knowledge, 4 items assessing attitudes, and 5 items assessing practices. Response formats varied, with some items requiring “Yes” or “No” answers, while others involved selecting from multiple-choice options. Each correct response was awarded one point, and incorrect responses received zero. The maximum possible scores were 8 for knowledge, 4 for attitude, and 5 for practice. An 80% threshold was used to categorize responses. Knowledge scores of 0–5 were classified as inadequate, while scores of 6–8 indicated adequate knowledge. For attitudes, scores of 0–2 reflected a negative attitude, and 3–4 a positive attitude. Practice scores of 0–3 denoted poor practices, whereas scores of 4–5 indicated good practices. Statistical analysis Data were entered and cleaned using Microsoft Excel 2016, and analyzed with GraphPad Prism version 8.0 and Statistical Package for Social Science (SPSS) version 26.0. Categorical variables were summarized using frequencies and percentages. Univariate and multivariate logistic regression analyses were computed to identify independent factors influencing inadequate knowledge, negative attitude and bad practice towards antibiotics use among participants. A p -value < 0.05 was considered statistically significant. RESULTS Sociodemographic characteristics of the study participants. Of all the 233 students participated, 137 (58.8%) were female and 96 (41.2%) males and were mostly single 227 (97.4%). The sample was predominantly young, with 223 (95.7%) aged 18–24 and 10 (4.3%) aged 25–30. A larger proportion of them were Christians 219 (94.0%) with few being Muslims 14 (6.0%). By academic level, 32 (13.7%) were 100-level, 55 (23.6%) 200-level, 62 (26.6%) 300-level and 84 (36.1%) 400-level (third- and fourth-year students together accounted for 62.7%). Regarding program distribution, Medical Laboratory Technology students formed the largest group 123 (52.8%), followed by Nursing 41 (17.6%), Midwifery 26 (11.2%), Physiotherapy 25 (10.7%), and Medical Imaging 18 (7.7%). Most participants lived off-campus (164; 70.4%) while 69 (29.6%) resided on campus. Table 1: Sociodemographic characteristics of the study participants. Variable N = 233 Frequency (%) Gender Male 96 41.2 Female 137 58.8 Age (years) 18-24 223 95.7 25-30 10 4.3 Marital status Single 227 97.4 Married 4 1.7 Cohabiting 2 0.9 Religion Christians 219 94.0 Muslims 14 6.0 Level of Study 100 32 13.7 200 55 23.6 300 62 26.6 400 84 36.1 Program of Study Medical Imaging 18 7.7 Medical Laboratory Technology 123 52.8 Midwifery 26 11.2 Nursing 41 10.7 Physiotherapy 25 29.6 Place of Residence On campus 69 29.6 Of campus 164 70.4 Knowledge of antibiotic use Overall, participant knowledge of antibiotic use was reasonably high but with important gaps. Most respondents 173 (74.2%) reported having received formal training on appropriate antibiotic use, predominantly from university schools 182 (78.1%), with smaller contributions from the Ministry of Health 34 (14.6%) and WHO training 8 (3.4%). Self-rated knowledge regarding appropriate antibiotic use was largely positive as 116 (49.8%) rated themselves as having moderate knowledge regarding appropriate antibiotic use, 79 (33.9%) as high and 26 (11.2%) very high (only 5.2% rated it low/very low). However, misconceptions remain as 31 (13.3) believed antibiotics are effective against viruses with 58 (24.9%) too being unsure. Again, 103 (44.2%) thought all antibiotics are safe indicating gaps in core conceptual and safety knowledge despite formal training. Encouragingly, nearly all participants 217 (93.1%) agreed that increased exposure to information on appropriate antibiotic use would change patterns of use ( Table 2 ). Complying with 80% cutoff, majority of the study participants had adequate knowledge towards antibiotics use (77.3%), while the remaining participants had inadequate knowledge towards antibiotics use (22.7%) ( Figure 1a ). Table 2: Assessment of participant knowledge on antibiotic use. Variable Response n (%) Received formal training on appropriate antibiotic use Yes 173 (74.2) No 60 (25.8) Trainer Ministry of Health Ghana 34 (14.6) W.H.O Training Ghana 8 (3.4) University Schools 182 (78.1) Others 9 (3.9) Effectiveness of antibiotics against viruses Yes 31 (13.3) No 144 (61.8) Not sure 58 (24.9) Infections for which antibiotics are used For viral infection 7 (3.0) For bacterial infection 223 (95.7) Fever 3 (1.3) Rate of knowledge regarding appropriate antibiotic use Very low 3 (1.3) Low 9 (3.9) Moderate 116 (49.8) High 79 (33.9) Very high 26 (11.2) All antibiotics considered safe for use Yes 103 (44.2) No 105 (45.1) Not sure 25 (10.7) Increased exposure to info on appropriate antibiotic use affecting patterns of use Yes 217 (93.1) No 8 (3.45) Not sure 8 (3.45) Attitudes towards Antibiotic use Participants displayed a mix of positive and problematic attitudes toward antibiotic use. A large majority reported the desirable behavior of taking antibiotics only after laboratory confirmation 203 (87.1%), and most recognized that prescribed antibiotics are not always effective 119 (51.1%), indicating reasonable awareness of limits to antibiotic efficacy. However, attitudes that risk inappropriate use were common as 108 (46.4%) admitted they stop antibiotics when symptoms improve, while 101 (43.3%) reported they do not, and only 23 (9.9%) insisted on taking antibiotics only when prescribed, with 210 (90.1%) not insisting on prescription-only use ( Table 3 ). Overall, 67.4% of the study participants had positive attitude towards antibiotics use with 32.6% of them having negative attitude towards antibiotics use ( Figure 1b ). Table 3: Assessment of participants’ attitudes toward antibiotic use Variable Response n (%) Taking antibiotics only after laboratory confirmation Yes 203 (87.1) No 18 (7.7) Not sure 12 (5.2) Prescribed antibiotics always effective Yes 94 (40.3) No 119 (51.1) Not sure 20 (8.6) Cease antibiotic regimen when symptoms improve Yes 108 (46.4) No 101 (43.3) Not sure 24 (10.3) Insistence on taking only prescribed antibiotics Yes 23 (9.9) No 210 (90.1) Appropriate antibiotics use practices When feeling unwell, most of the students would go to hospital for testing 134 (57.5%), while a substantial minority would buy drugs from a pharmacy without testing 92 (39.5%) and few would borrow antibiotics 7 (3.0%). For treating a family member, 155 (66.5%) would take them to hospital, 63 (27.0%) would buy drugs from a pharmacy, and 15 (6.5%) would give leftover medication, a behavior that enables inappropriate use. Antibiotics were obtained mainly from hospitals 123 (52.8%) and local pharmacies 103 (44.2%), with friends/family accounting for only 7 (3.0%). Healthcare providers were the leading source of information on antibiotic acquired for treatment 140 (60.1%), followed by the internet 68 (29.2%), then family/friends 18 (7.7%) and others 7 (3.0%). Importantly, 202 (86.7%) agreed or strongly agreed that poor antibiotic use contributes to drug ineffectiveness, indicating strong awareness of the problem ( Table 4 ). Overall, 50.6% of participants demonstrated poor practices regarding antibiotic use, while 49.4% demonstrated good practices ( Figure 1c ). Table 4: Assessment of appropriate antibiotics use practices Variable Response n (%) Immediate action when feeling unwell Buy a drug from Pharmacy 92 (39.5) Go to Hospital for test 134 (57.5) Borrow antibiotic from a friend or family member 7 (3.0) Immediate recommended action when family/friend reports unwellness Take them to the hospital 155 (66.5) Buy drug from pharmacy 63 (27.0) Give them remaining drug 15 (6.5) Mode of acquisition of antibiotics Local Pharmacy 103 (44.2) Hospitals 123 (52.8) Friends and Family 7 (3.0) Source of information on antibiotics acquired for treatment Healthcare providers 140 (60.1) Internet 68 (29.2) Family/friends 18 (7.7) Others 7 (3.0) Assessment of poor antibiotic use contributing to drug ineffectiveness Strongly agree 107 (45.9) Agree 95 (40.8) Disagree 26 (11.2) Strongly disagree 5 (2.1) Commonly used antibiotics by study participants Amoxicillin predominated, reported by 153 (65.7%) of participants, followed by metronidazole 21 (9.0%), other agents 22 (9.4%), penicillin 18 (7.7%), ciprofloxacin 16 (6.9%), and erythromycin 3 (1.3%). This pattern depicts a heavy reliance on a single, widely available broad-spectrum agent likely reflects amoxicillin’s affordability, accessibility and role as a common first-line empirical choice, and may also signal frequent self-treatment or non-targeted prescribing. Factors associated with inadequate knowledge towards antibiotics use among tertiary students In the univariate analysis, female compared to male (cOR; 0.98, 95% CI; 0.53-1.83, p =0.959), age bracket 25–30 compared to 18–24 (cOR; 0.37, 95% CI; 0.05-2.95, p =0.365) and being Muslim compared to Christian (cOR 0.25, 95% CI; 0.03-1.93, p =0.183) showed reduced and no significant likelihood of inadequate knowledge towards antibiotics use. By level of study, level 200 students showed trend toward reduced likelihood (cOR 0.43, 95% CI;0.18-1.05, p =0.064) and level 300 students had markedly lower likelihood (cOR; 0.11, 95% CI; 0.04-0.32, p <0.001). Again, the level 400 students had a reduced likelihood of having inadequate knowledge towards antibiotics use compared to level 100 students (cOR; 0.13, 95% CI; 0.05-0.34, p <0.001). Among programs, physiotherapy students showed higher likelihood of having inadequate knowledge towards antibiotics use (cOR 4.46, 95% CI; 1.14–17.41, p =0.032) compared to Medical Imaging students. Bad practice compared to good practice (cOR; 0.60, 95% CI; 0.32-1.12, p =0.109) and negative attitude compared to positive attitude (cOR; 0.83, 95% CI; 0.44-1.58, p =0.568) were not associated with the likelihood of having inadequate knowledge towards antibiotics use. After adjustment, the academic-level gradient remained the only robust independent predictor of having inadequate knowledge towards antibiotics use; compared with level 100 students, level 200 students (aOR; 0.32, 95% CI; 0.12–0.87, p =0.025), 300-level (aOR; 0.09, 95% CI; 0.03–0.27, p <0.001) and level 400 students (aOR; 0.12, 95% CI; 0.04–0.34, p <0.001) had significantly lower odds of inadequate knowledge. The crude excess risk seen in physiotherapy was diminished and non-significant after adjustment (aOR; 3.44, 95% CI; 0.78-15.29, p =0.104). Table: Factors associated with inadequate knowledge towards antibiotics use among tertiary students Inadequate Knowledge Variable cOR (95% CI) p-value aOR (95% CI) p-value Gender Male* 1.00 - Female 0.98(0.53-1.83) 0.959 Age (years) 18-24* 1.00 - 25-30 0.37(0.05-2.95) 0.365 Religion Christians* 1.00 - Muslims 0.25(0.03-1.93) 0.183 Level of Study 100* 1.00 - 1.00 - 200 0.43(0.18-1.05) 0.064 0.32(0.12-0.87) 0.025 300 0.11(0.04-0.32) <0.001 0.09(0.03-0.27) <0.001 400 0.13(0.05-0.34) <0.001 0.12(0.04-0.34) <0.001 Program of Study Medical Imaging* 1.00 - 1.00 - Medical Laboratory Technology 0.81(0.24-2.67) 0.723 0.70(0.19-2.57) 0.597 Midwifery 1.56(0.39-6.24) 0.533 1.13(0.25-5.22) 0.874 Nursing 0.38(0.08-1.72) 0.209 0.23(0.04-1.19) 0.079 Physiotherapy 4.46(1.14-17.41) 0.032 3.44(0.78-15.29) 0.104 Practice Bad* 1.00 - Good 0.60(0.32-1.12) 0.109 Attitude Negative* 1.00 - Positive 0.83(0.44-1.58) 0.568 Factors associated with negative attitude towards antibiotics use among tertiary students In the univariate analysis, most sociodemographic factors were not associated with the likelihood of having negative attitude toward antibiotic use. Although not statistically significant, being Muslims compared to Christians (cOR; 1.60, 95% CI; 0.53–4.78, p =0.403) was associated with an increased chance of having a negative attitude towards antibiotics use. Female students (cOR: 0.74; 95% CI: 0.43–1.30; p = 0.296), compared to their male counterparts, and students aged 25–30 years (cOR: 0.88; 95% CI: 0.22–3.50; p = 0.857), compared to those aged 18–24 years, demonstrated a reduced but statistically insignificant likelihood of having a negative attitude towards antibiotic use. Neither level of study nor program of study showed significant crude associations with negative attitudes toward antibiotic use. The only strong crude predictor was practice: respondents who demonstrated good antibiotic use practices had significantly lower odds of exhibiting a negative attitude compared to those with poor practices (cOR: 0.17; 95% CI: 0.09–0.33; p < 0.001). In contrast, adequate knowledge of antibiotic use was not significantly associated with attitude (cOR: 0.83; 95% CI: 0.44–1.58; p = 0.568). After adjusting for possible confounders in the multivariate analysis, good practice towards antibiotics use was the sole independent predictor of negative attitude towards antibiotics use, with participants reporting good practice having substantially lower adjusted odds of a negative attitude (aOR; 0.17, 95% CI; 0.09–0.33, p <0.001). Adjusted estimates for female (aOR; 1.02, 95% CI; 0.56–1.88, p =0.946) and age 25–30 (aOR; 0.73, 95% CI; 0.17–3.18, p =0.674) were non-significant, and other covariates did not show independent effects. Table: Factors associated with negative attitude towards antibiotics use among tertiary students Negative Attitude Variable cOR (95% CI) p-value aOR (95% CI) p-value Gender Male* 1.00 - 1.00 - Female 0.74(0.43-1.30) 0.296 1.02(0.56-1.88) 0.946 Age (years) 18-24* 1.00 - 1.00 - 25-30 0.88(0.22-3.50) 0.857 0.73(0.17-3.18) 0.674 Religion Christians* 1.00 - Muslims 1.60(0.53-4.78) 0.403 Level of Study 100* 1.00 - 200 0.93(0.37-2.33) 0.875 300 0.84(0.34-2.09) 0.713 400 0.96(0.40-2.25) 0.915 Program of Study Medical Imaging* 1.00 - Medical Laboratory Technology 1.00(0.35-2.86) >0.999 Midwifery 1.06(0.30-3.78) 0.930 Nursing 0.73(0.22-2.43) 0.612 Physiotherapy 1.13(0.31-4.03) 0.856 Practice Bad* 1.00 - 1.00 - Good 0.17(0.09-0.33) <0.001 0.17(0.09-0.33) <0.001 Knowledge Inadequate* 1.00 - Adequate 0.83(0.44-1.58) 0.568 Factors associated with bad practices towards antibiotics use among tertiary students In univariate binary logistic models, female students had significantly lower odds of having bad antibiotic practices than males (cOR; 0.44, 95% CI; 0.26–0.75, p = 0.003). Students with a positive attitude toward antibiotics use were much less likely to report bad practices compared to negative attitude (cOR; 0.17, 95% CI; 0.09–0.33, p < 0.001). Age, religious affiliation, level of study, program of study, and knowledge level were all not associated with the likelihood of having bad practices towards antibiotics use. After adjusting for other covariates for confounders, females compared to males (aOR; 0.44, 95% CI; 0.25–0.78, p =0.005) and having positive attitude toward antibiotics use were (aOR; 0.17, 95% CI; 0.09–0.33, p < 0.001) remained strong and statistically significant with reduced odds of having bad practices towards antibiotics use. Other factors like age, religion, level, program, and knowledge did not show independent effects. Table: Factors associated with bad practices towards antibiotics use among tertiary students Bad practices Variable cOR (95% CI) p-value aOR (95% CI) p-value Gender Male* 1.00 - 1.00 - Female 0.44(0.26-0.75) 0.003 0.44(0.25-0.78) 0.005 Age (years) 18-24* 1.00 - 25-30 1.49(0.41-5.41) 0.548 Religious Affiliation Christians 1.00 - Muslims 1.32(0.44-3.93) 0.617 Level of Study 100* 1.00 - 200 1.89(0.78-4.57) 0.159 300 1.28(0.54-3.05) 0.570 400 1.67(0.74-3.85) 0.215 Program of Study Medical Imaging* 1.00 - Medical Laboratory Technology 1.71(0.63-4.62) 0.293 Midwifery 0.66(0.19-2.27) 0.511 Nursing 0.89(0.29-2.71) 0.831 Physiotherapy 1.35(0.40-4.57) 0.625 Knowledge Inadequate* 1.00 - Adequate 0.60(0.32-1.12) 0.109 Attitude Negative* 1.00 - 1.00 - Positive 0.17(0.09-0.33) <0.001 0.17(0.09-0.33) <0.001 DISCUSSION The inappropriate use of antibiotics is a major contributor to antimicrobial resistance, a growing public health threat in low-and middle-income countries. Assessing the level of knowledge, attitude and practices towards appropriate antimicrobial use will serve as a great resource in the fight against AMR. In this current study, we assessed the knowledge, attitudes and practices of antibiotic use among tertiary students in a Ghanaian tertiary institution and found that knowledge was generally adequate but key gaps remained. Practices were mixed as 57.5% seek hospital testing but 39.5% buy from pharmacies without tests, with 6.5% sharing leftover antibiotics. Overall, 77.3% had adequate knowledge, with 67.4% also having a positive attitude towards antibiotic use. Slightly above half of them (50.6%) also had poor practices towards appropriate antibiotics use with amoxicillin being the most used (65.7%). Our findings revealed that a significant proportion of students (74.2%) had received formal education on appropriate antibiotic use with 78.1% of the training coming from the university. This indicates that universities are the main training source of appropriate antibiotic use for the participants and are good platforms for curricular interventions and stewardship integration. Similarly, Sefah (2022) reported that 79.4% of healthcare students surveyed had not received any training on antibiotics before entering university, highlighting the fact that their primary exposure to antibiotic knowledge and stewardship occurred during university education. Although the overall knowledge of antibiotic use in this study was encouraging, important gaps persist. Using an 80% cutoff, 77.3% of participants demonstrated adequate knowledge; however, 13.3% still believed that antibiotics are effective against viruses, and 24.9% were uncertain. Additionally, 44.2% thought that “all antibiotics are safe,” highlighting conceptual misunderstandings despite formal training. Comparable results have been reported among Polish medical students, where 3% and 6% continued to believe antibiotics could treat viral infections such as influenza and the common cold, and misconceptions regarding resistance and safety remained (Sobierajski et al., 2021). Therefore, integrating targeted modules on antibiotic usage, safety, and resistance into educational curricula is essential to address these gaps and promote responsible antibiotic use. Similarly, Owusu-Ofori (2021) observed that while 94.1% of healthcare students correctly identified that antibiotics treat bacterial infections, only 66.9% recognized that antibiotics are ineffective against viral infections meaning 33.1% held the misconception that antibiotics can cure viruses. This parallel misperception underscores that even with generally good knowledge levels, substantial gaps in understanding antibiotic indications and safety endure, reinforcing the need for targeted curriculum modules on antibiotic usage, adverse effects, and safety across educational institutions. Academic level was significantly associated with reduced odds of inadequate knowledge regarding antibiotic use. Multivariate analysis revealed progressively lower adjusted odds in 200-level (aOR: 0.32), 300-level (aOR: 0.09), and 400-level students (aOR: 0.12) compared to those in 100-level, with all associations reaching statistical significance (p ≤ 0.025). These findings suggest that academic progression, not program of study, drives knowledge in appropriate antibiotics use, therefore interventions should prioritize early (first year) students. A relevant comparison comes from who investigated healthcare students’ antibiotic knowledge in Ghana. Their multivariable logistic regression showed that fifth-year students were approximately six times more likely to have good overall knowledge of antibiotics compared to fourth-year students (a OR = 5.84; p = 0.001) (Sefah et al., 2022b). This mirrors our finding of progressive knowledge gains across academic years, reinforcing that year of study plays a significant role in antibiotic literacy. While knowledge is crucial, attitudes also tend to play a significant role in shaping patterns of antibiotic use. Majority of the participants (67.4%) had positive attitude with 87.1% also reporting taking antibiotics only after lab confirmation. Majority (51.1%) also acknowledged that prescribed antibiotics are not always effective. These findings contrast with results from healthcare student surveys in other contexts. Sefah’s work in Ghana reported that most students obtain antibiotics via a medical prescription (89.4%) but also documented substantial variation in knowledge and access-related behaviors across cohorts, with differences linked to year and course of study (Sefah et al., 2022b). Collectively, these findings suggest that while baseline attitudes are favorable in certain areas, they present opportunities that can be strengthened through stewardship training. When compared with the systematic review and meta-analysis by Atalay & Abebe Gelaw, (2024), the contrast becomes more pronounced. Their pooled analysis across 28 studies in Africa found that only 46.93% of participants exhibited positive attitudes toward antimicrobial resistance (AMR), with tertiary students showing the highest prevalence at 55.81% (Atalay & Abebe Gelaw, 2024). This is notably lower than the 67.4% positive attitude observed in the current study, suggesting that the surveyed population may have a relatively more favorable disposition toward responsible antibiotic use. Despite the generally positive attitudes toward antibiotic use, problematic behaviors persist among tertiary students. In the present study, 46.4% reported discontinuing antibiotics once symptoms improved, and only 9.9% consistently adhered to prescribed antibiotic regimens. Comparable findings emerge from a survey of university students in Thailand (across both health and non-health fields), where a striking 65% reported discontinuing antibiotic treatment when they felt better, despite many also following doctor’s instructions in other respects (Precha et al., 2024). Good practice was the only independent predictor of reduced odds of having a negative attitude (aOR: 0.17; p < 0.001), underscoring that strengthening concrete behaviors may help mitigate negative attitudes. These findings suggest that interventions should integrate behavioral skill-building with attitudinal education to effectively promote appropriate antibiotic use. This aligns with findings from a multicenter cross-sectional study in Saudi Arabia, where higher knowledge was significantly associated with improved practices and more positive attitudes toward antibiotic use (χ², p < 0.001; and a positive moderate correlation, r = 0.406, p < 0.001) (Shrestha & Rajbhandari, 2018). These findings reinforce that enhancing concrete behaviors through knowledge-driven skill development and can substantially shift attitudes, underscoring the need for integrated interventions that fuse practical competency with attitude transformation. Mixed but concerning practices were also observed in this current study as majority of the participants (50.6%) were classified as having poor practice towards appropriate antibiotics use. Comparable findings have been documented across different countries. Study conducted in Nigerian reported that while only 29.8% of undergraduates had good practice, 26.5% exhibited poor practice and 67.0% demonstrated merely fair practice, with significant correlations between poor knowledge and poor practice ( p < 0.037) (Onukansi et al., 2025). In Bangladesh, among university students during the COVID-19 era, 40.4% of 18–21-year-olds were categorized as having poor antibiotic practices (Wahab et al., 2023). In Ghana, a 2012 study among tertiary students in Accra revealed that 46% failed to complete the full antibiotic course, and 49% had poor knowledge about the consequences of irrational use of antibiotics (Donkor et al., 2012). Together, these studies suggest that poor antibiotic practice particularly non-adherence to prescribed regimens and self-medication, is a widespread phenomenon among university students globally. These disparities likely stem from gaps in health literacy, differing access to credible prescribing information, and insufficient emphasis on antibiotic stewardship in curricula and public health messaging. Hence, integrating tailored behavioral interventions such as simulated case-based prescribing, reminders for course completion, and improved health education into university programs could help mitigate these persistent gaps. Again, more than half of the participants (57.5%) reported that they would go to the hospital for testing when they are unwell, while 39.5% buy antibiotics from the pharmacy without testing with 6.5% giving leftover drugs to others. These findings imply that while formal care-seeking is common, self-medication and sharing remain important misuse drivers which need both enforcement and education. In a study conducted among health science students in Ghana, Nyarko (2025) found that self-medication with antimicrobial drugs was prevalent, with 44.67% of respondents reporting use without prescription and 51.33% having done so within the past year (Nyarko et al., 2025). Ampicillin was the most used non-prescription antibiotic, typically obtained from pharmacies (52.33%). These practices reflect a pattern of informal antibiotic use that bypasses diagnostic confirmation, contributing to inappropriate consumption and potential antimicrobial resistance. With respect to participants’ sources and information on antibiotics for treatment, antibiotics mainly acquired from the hospitals (52.8%) and local pharmacies (44.2%) were the major sources for acquiring antibiotics with their primary information source being healthcare providers (60.1%), and the internet (29.2%) implying that pharmacies are a key intervention point to enforce prescription-only dispensing, also healthcare providers and online channels can be used for stewardship messaging. In a meta-analysis of self-medication practices in Ghana, Opoku (2023) reported that pharmacies were consistently identified as a major source of antibiotics, particularly in urban settings where access to drug outlets is widespread. This supports the assertion that pharmacies represent a critical intervention point for enforcing prescription-only policies. Again, being a female (aOR 0.44, p =0.005) coupled with having a positive attitude towards appropriate antibiotics use (aOR 0.17, p <0.001) remained independent predictors of lower odds of bad practices indicating that male students should be targeted with tailored behavior-change programs and strengthening attitudes among tertiary students can translate into better practices. In a comparative analysis of pharmacy and non-pharmacy students at the University of Ghana, Amponsah (2022) reported that female students were more likely to engage in self-medication than males, yet they also demonstrated greater caution and ambivalence toward the practice. Among pharmacy students, 61.7% of females self-medicated compared to 49.4% of males, while among non-pharmacy students, 52.6% of females self-medicated versus 48.8% of males. Despite these rates, the study found that a substantial proportion of students, 36.8% of pharmacy and 27.6% of non-pharmacy exhibited ambivalent attitudes toward self-medication, suggesting that attitudes may mediate the relationship between gender and practice (Amponsah et al., 2022). Amoxicillin dominated the commonly used antibiotics among the tertiary students (65.7%) followed by metronidazole (9.0%), ciprofloxacin (6.9%), penicillin (7.7%), and erythromycin (1.3%) and this clearly show that there is a heavy reliance on a single broad-spectrum agent raising resistance concerns therefore emphasis should be placed on guideline-based empirical therapy and local resistance surveillance. When compared with the systematic review and meta-analysis by Belachew (2021) the trend appears consistent across Sub-Saharan Africa. It was reported by Belachew (2021) that amoxicillin (26.5%) and co-trimoxazole (19.8%) were the most frequently dispensed antibiotics without prescription across community drug retail outlets (CDROs) in the region. Their findings revealed that upper respiratory tract infections and acute diarrhea often viral and self-limiting were the leading reasons for antibiotic requests, with amoxicillin being the preferred agent despite its broad-spectrum nature Belachew (2021). Conversely, Nyarko (2025) also found that ampicillin was the most used non-prescription antibiotic, typically obtained from pharmacies in their study conducted among health science students in Ghana (Nyarko et al., 2025). This widespread use, often without diagnostic confirmation, contributes to inappropriate consumption and accelerates resistance development While the findings provide valuable insights, these limitations must be considered. Our sample (n = 233) is smaller than the conventional target for ±5% precision in a population of about 2,000, which reduced the precision of proportion estimates (achieved ME ≈ ±6.00%). Even though we reported confidence intervals where appropriate, and used adjusted regression models to improve efficiency and reduce bias to show the robustness of our findings, future studies should recruit a large sample size to have a true representation of the general population. Again, the sample skewed toward one program and young students may also affect our results and may not be a true representation of the general population. Future research should also evaluate the impact of early curricular stewardship interventions and pharmacy enforcement on knowledge, attitudes and practices over time (pre-post or cohort studies). Recommendations We recommend immediate integration of antibiotic stewardship into the undergraduate curriculum through mandatory, competency-based modules that combine targeted teaching with case-based exercises to translate knowledge into practice, aimed specifically at first-year students and students who exhibit higher odds of poor practice. These educational efforts should be reinforced by regular multidisciplinary workshops and student-led peer education, while campus policies that limit nonprescription access to antibiotics developed in collaboration with university health services, pharmacies, and the Ministry of Health will help reduce self-medication. Progress should be tracked using KAP indicators and rates of nonprescription acquisition, and these data should be used to refine interventions. Additionally, longitudinal and qualitative studies are needed to understand barriers to sustained behavior change and to evaluate the long-term impact of educational initiatives. Conclusion In this cohort of tertiary health students, knowledge of antibiotic use was generally adequate but important misconceptions persisted. Crucially, academic progression was the only robust independent predictor of knowledge, indicating that stewardship efforts should be introduced early in the curriculum. Again, despite generally positive attitudes and frequent reliance on hospitals or healthcare providers for antibiotics, half of the participants reported poor practices towards appropriate antibiotics use and heavy self-reported use of amoxicillin, underscoring the need for combined educational, policy and surveillance interventions. Declarations Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Ethics approval and consent to participate Ethical approval for this study was obtained from the Committee on Human Research, Publications and Ethics (CHRPE/AP/207/24) of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, prior to the commencement of the study. Written informed consent was obtained from all participants before enrollment. To maintain confidentiality and protect participants’ identities, unique identification numbers were used instead of names throughout data collection and analysis. Clinical Trial Number Not applicable. Consent for publication Not applicable. Authors' contributions Kinako Denis Elia Dazangapai conceptualized and conducted the study, collected the data, and together with Michael Nkrumah-Appau and Richard Owusu Ansah analyzed the data. Alex Owusu-Ofori supervised the study and critically revised the manuscript for important intellectual content. Eric Darko, Barikisu Ekua Seidu Dawuda, Beatrice Nyantakyiwaa, Richard Larbi, James Opoku Frimpong, and Raymond Xornam Sevor contributed to the literature review, drafting, and editing of the manuscript. All authors read and approved the final version of the manuscript. Competing interests The authors declare that they have no competing interests. Dual Publication This manuscript is original and is not under consideration elsewhere, nor has it been previously published in whole or in part elsewhere, in any language. All sources are appropriately cited. Permission to Use Third‑Party Material All figures, tables, and text excerpts reproduced from other sources are accompanied by full citations. Where necessary, permission has been obtained from copyright holders and is available upon request. Availability of data and materials Data and materials for the study are available upon request from the corresponding authors. Acknowledgements Not applicable. References Amponsah, S. 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use\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7703640/v1/128ddad3824f0e9e59be6c26.png"},{"id":93250800,"identity":"647fa387-5f3e-4554-be36-f413fb0b2b75","added_by":"auto","created_at":"2025-10-10 15:45:02","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":64388,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eCommonly used antibiotics by study participants\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7703640/v1/40a0ed1e6311977d71e36d71.png"},{"id":101151860,"identity":"0f146a6b-aa60-4dbe-9362-7723648c6c17","added_by":"auto","created_at":"2026-01-26 16:07:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1828135,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7703640/v1/a2205dfd-3c09-42c7-84fd-1234e32a40c2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge, Attitudes and Practices of Antibiotic Use Among Students in A Ghanaian Tertiary Institution","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe inappropriate use of antibiotics is a major contributor to antimicrobial resistance, a growing public health threat in low-and middle-income countries (LMICs). This resistance leads to treatment failures and increased morbidity and mortality (Ndaki et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAntimicrobial resistance (AMR), driven especially by antibiotic misuse, threatens to undermine decades of advancements in healthcare. Education is a cornerstone in combating AMR, as evidenced by significant improvements in the understanding of antibiotic use and resistance (Sharma et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Antibiotic misuse, as defined by the World Health Organization (WHO), encompasses various inappropriate practices related to antibiotics (WHO 2021). These include overuse, self-medication, and incomplete treatment. Such practices can lead to the emergence of antibiotic-resistant strains, posing a significant global health challenge (Sakeena et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn 2019, the global burden of antimicrobial resistance (AMR) was estimated to be responsible for 4.95\u0026nbsp;million deaths (D\u0026rsquo;Arcy et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Projections indicate that by 2050, this figure will escalate to 10\u0026nbsp;million deaths worldwide. Specifically, Africa and Asia are expected to bear the impact, accounting for 4.15\u0026nbsp;million and 4.73\u0026nbsp;million deaths, respectively. This continuous spread of AMR emphasizes the urgent need for comprehensive strategies to fight this critical health challenge (Appiah et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eHealthcare students are crucial stakeholders in combating AMR due to their future roles as care providers. Their knowledge and attitudes thus significantly influence the effectiveness of antimicrobial stewardship (AMS) programs (Sefah et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2022a\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRecent studies in LMICs, such as among college students in Eritrea show that over 65% of students self-medicated with antibiotics Gebregziabher (2024), while a study conducted among undergraduate medical students in Eastern Uganda reported a staggering 93.8% prevalence of self-medication of antibiotics, with common conditions such as diarrhea, peptic ulcers, and painful wounds being self-treated using antibiotics like amoxicillin and metronidazole (Nakato et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). However, on the other hand, most health students demonstrated good foundational knowledge of antibiotics' efficacy against bacterial infections and also acknowledged the menace of antibiotic misuse (Bonna et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThese studies highlight the gaps in knowledge and practice of proper AMS among allied health sciences students who are crucial stakeholders in the global fight against AMR. A testament to this is how in Ghana, some studies highlighted the critical gaps in knowledge about AMR among healthcare seekers. Importantly, exposure to tailored educational interventions at the point of care by allied health staff significantly improved participants' willingness to adopt AMR mitigation strategies (Otieku et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTherefore, assessing and plucking knowledge gaps among allied health students, in the short and medium term will serve as a great resource in the fight against AMR as their optimum knowledge, attitudes and practice of good antimicrobial use will translate into their profession and practice (Kimbowa IM et al., 2024). Therefore, this study aimed to investigate knowledge, attitudes and practices of antibiotic use among students in a public university pursuing bachelor\u0026rsquo;s degrees in allied healthcare programs.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy design and site\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis employed a cross-sectional study to investigate the level of knowledge, attitude, and practices of appropriate antibiotics use among health students at the Faculty of Allied Health Sciences of the Kwame Nkrumah University of Science and Technology (KNUST) from May to August 2024. KNUST is the second largest university in Ghana located in Kumasi, the capital of The Ashanti region. It is organized into six colleges including Agriculture and Natural Resources, Art and Built Environment, Humanities and Social Sciences, Engineering, Health Sciences, and Science.\u0026nbsp;Each college houses various faculties that offer degree programs across many academic disciplines, providing a comprehensive university experience. The Faculty of Allied Health Sciences, under the College of Health Sciences, has an estimated student population of approximately 2,000, drawn from various healthcare programs including Medical Laboratory Science, Nursing, Midwifery, Medical Imaging, and Physiotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population, inclusion and exclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study targeted undergraduate health science students aged \u0026ge;18 years, who were formally enrolled in Bachelor of Science degree programs in Medical Laboratory Science, Nursing, Midwifery, Medical Imaging, and Physiotherapy at the Faculty of Allied Health Sciences, KNUST. Eligibility criteria included active enrollment status and possession of a valid institutional student identification card bearing a unique identification number regardless of level of study, confirming their affiliation with the university. These criteria were established to ensure that participants were legitimate members of the university community and appropriately represented the target population for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size estimation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSample size calculations using conservative assumptions (\u003cem\u003ep\u003c/em\u003e = 0.5, 95% confidence) and Cochran\u0026rsquo;s formula with finite population correction [\u003cem\u003en=N*Z\u003csup\u003e2\u003c/sup\u003e*p(1-p)/e\u003csup\u003e2\u003c/sup\u003e(N-1) + Z\u003csup\u003e2\u003c/sup\u003e*p(1-p)\u003c/em\u003e]\u003cem\u003e\u0026nbsp;\u003c/em\u003eindicated a target of approximately 323 participants for a \u0026plusmn;5% margin of error and a population, N=2000. Recruitment constraints meant we enrolled n = 233 participants, with this, precision for proportion estimates was approximately \u0026plusmn;6.00% (95% CI). Where appropriate, we presented adjusted estimates from regression models to align the sample with the target population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Committee on Human Research, Publications and Ethics (CHRPE/AP/207/24), at the Kwame Nkrumah University of Science and Technology, before commencing the study. Written informed consent was obtained from all participants prior to their involvement in the study. To ensure confidentiality and protect participants\u0026apos; identities, unique IDs were used in place of real names, thereby maintaining anonymity throughout the data collection and analysis processes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection technique and tools\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA simple random sampling technique was used to sample health students from the Faculty of Allied Health Sciences at KNUST. In the application of the simple random sampling technique, students\u0026apos; identification numbers were utilized to ensure the accurate selection of participants and to prevent the inclusion of duplicate respondents. This approach facilitated the maintenance of sample integrity and minimized selection bias. Face-to-face interviews were conducted using a well-structured, closed-ended questionnaire to collect data on health students\u0026rsquo; knowledge, attitudes, and practices regarding appropriate antibiotic use. The questionnaire was peer-reviewed and pilot tested before a final version was administered to participants. Participants were interviewed by the researchers and trained research assistants using the structured questionnaire. The first section of the questionnaire constituted the respondents\u0026rsquo; demographic characteristics whilst the remaining sections were designed based on the study\u0026rsquo;s specific objectives.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessment of Knowledge, Attitudes, and Practices (KAP)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo evaluate the level of knowledge, attitudes, and practices (KAP) regarding appropriate antibiotics use among the health students, a structured questionnaire consisting of 16 scoring items was administered. The questionnaire included 7 items assessing knowledge, 4 items assessing attitudes, and 5 items assessing practices. Response formats varied, with some items requiring \u0026ldquo;Yes\u0026rdquo; or \u0026ldquo;No\u0026rdquo; answers, while others involved selecting from multiple-choice options.\u003c/p\u003e\n\u003cp\u003eEach correct response was awarded one point, and incorrect responses received zero. The maximum possible scores were 8 for knowledge, 4 for attitude, and 5 for practice. An 80% threshold was used to categorize responses. Knowledge scores of 0\u0026ndash;5 were classified as inadequate, while scores of 6\u0026ndash;8 indicated adequate knowledge. For attitudes, scores of 0\u0026ndash;2 reflected a negative attitude, and 3\u0026ndash;4 a positive attitude. Practice scores of 0\u0026ndash;3 denoted poor practices, whereas scores of 4\u0026ndash;5 indicated good practices.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were entered and cleaned using Microsoft Excel 2016, and analyzed with GraphPad Prism version 8.0 and Statistical Package for Social Science (SPSS) version 26.0. Categorical variables were summarized using frequencies and percentages. Univariate and multivariate logistic regression analyses were computed to identify independent factors influencing inadequate knowledge, negative attitude and bad practice towards antibiotics use among participants. A \u003cem\u003ep\u003c/em\u003e-value \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic characteristics of the study participants.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf all the 233 students participated, 137 (58.8%) were female and 96 (41.2%) males and were mostly single 227 (97.4%). The sample was predominantly young, with 223 (95.7%) aged 18\u0026ndash;24 and 10 (4.3%) aged 25\u0026ndash;30. A larger proportion of them were Christians 219 (94.0%) with few being Muslims 14 (6.0%). By academic level, 32 (13.7%) were 100-level, 55 (23.6%) 200-level, 62 (26.6%) 300-level and 84 (36.1%) 400-level (third- and fourth-year students together accounted for 62.7%). Regarding program distribution, Medical Laboratory Technology students formed the largest group 123 (52.8%), followed by Nursing 41 (17.6%), Midwifery 26 (11.2%), Physiotherapy 25 (10.7%), and Medical Imaging 18 (7.7%). Most participants lived off-campus (164; 70.4%) while 69 (29.6%) resided on campus.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Sociodemographic characteristics of the study participants.\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"582\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN = 233\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e58.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e95.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e25-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e97.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eCohabiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eChristians\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e94.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eMuslims\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e23.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e26.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e36.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProgram of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eMedical Imaging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eMedical Laboratory Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e52.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eMidwifery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003ePhysiotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e29.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of Residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eOn campus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e29.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 240px;\"\u003e\n \u003cp\u003eOf campus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 197px;\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e70.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge of antibiotic use\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverall, participant knowledge of antibiotic use was reasonably high but with important gaps. Most respondents 173 (74.2%) reported having received formal training on appropriate antibiotic use, predominantly from university schools 182 (78.1%), with smaller contributions from the Ministry of Health 34 (14.6%) and WHO training 8 (3.4%). Self-rated knowledge regarding appropriate antibiotic use was largely positive as 116 (49.8%) rated themselves as having moderate knowledge regarding appropriate antibiotic use, 79 (33.9%) as high and 26 (11.2%) very high (only 5.2% rated it low/very low). However, misconceptions remain as 31 (13.3) believed antibiotics are effective against viruses with 58 (24.9%) too being unsure. Again, 103 (44.2%) thought all antibiotics are safe indicating gaps in core conceptual and safety knowledge despite formal training. Encouragingly, nearly all participants 217 (93.1%) agreed that increased exposure to information on appropriate antibiotic use would change patterns of use (\u003cstrong\u003eTable 2\u003c/strong\u003e). Complying with 80% cutoff, majority of the study participants had adequate knowledge towards antibiotics use (77.3%), while the remaining participants had inadequate knowledge towards antibiotics use (22.7%) (\u003cstrong\u003eFigure 1a\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2:\u003c/strong\u003e \u003cstrong\u003eAssessment of participant knowledge on antibiotic use.\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"636\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cem\u003eReceived formal training on appropriate antibiotic use\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e173 (74.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e60 (25.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cem\u003eTrainer\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eMinistry of Health Ghana\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e34 (14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eW.H.O Training Ghana\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e8 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eUniversity Schools\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e182 (78.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e9 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cem\u003eEffectiveness of antibiotics against viruses\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e31 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e144 (61.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e58 (24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cem\u003eInfections for which antibiotics are used\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eFor viral infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e7 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eFor bacterial infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e223 (95.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eFever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e3 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cem\u003eRate of knowledge regarding appropriate antibiotic use\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eVery low\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e3 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e9 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eModerate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e116 (49.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e79 (33.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eVery high\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e26 (11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cem\u003eAll antibiotics considered safe for use\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e103 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e105 (45.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e25 (10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cem\u003eIncreased exposure to info on appropriate antibiotic use affecting patterns of use\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e217 (93.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e8 (3.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e8 (3.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttitudes towards Antibiotic use\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants displayed a mix of positive and problematic attitudes toward antibiotic use. A large majority reported the desirable behavior of taking antibiotics only after laboratory confirmation 203 (87.1%), and most recognized that prescribed antibiotics are not always effective 119 (51.1%), indicating reasonable awareness of limits to antibiotic efficacy. However, attitudes that risk inappropriate use were common as 108 (46.4%) admitted they stop antibiotics when symptoms improve, while 101 (43.3%) reported they do not, and only 23 (9.9%) insisted on taking antibiotics only when prescribed, with 210 (90.1%) not insisting on prescription-only use (\u003cstrong\u003eTable 3\u003c/strong\u003e). Overall, 67.4% of the study participants had positive attitude towards antibiotics use with 32.6% of them having negative attitude towards antibiotics use (\u003cstrong\u003eFigure 1b\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Assessment of participants\u0026rsquo; attitudes toward antibiotic use\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"594\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cem\u003eTaking antibiotics only after laboratory confirmation\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e203 (87.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e18 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e12 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cem\u003ePrescribed antibiotics always effective\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e94 (40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e119 (51.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e20 (8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cem\u003eCease antibiotic regimen when symptoms improve\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e108 (46.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e101 (43.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e24 (10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cem\u003eInsistence on taking only prescribed antibiotics\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e23 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e210 (90.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAppropriate antibiotics use practices\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhen feeling unwell, most of the students would go to hospital for testing 134 (57.5%), while a substantial minority would buy drugs from a pharmacy without testing 92 (39.5%) and few would borrow antibiotics 7 (3.0%). For treating a family member, 155 (66.5%) would take them to hospital, 63 (27.0%) would buy drugs from a pharmacy, and 15 (6.5%) would give leftover medication, a behavior that enables inappropriate use. Antibiotics were obtained mainly from hospitals 123 (52.8%) and local pharmacies 103 (44.2%), with friends/family accounting for only 7 (3.0%). Healthcare providers were the leading source of information on antibiotic acquired for treatment 140 (60.1%), followed by the internet 68 (29.2%), then family/friends 18 (7.7%) and others 7 (3.0%). Importantly, 202 (86.7%) agreed or strongly agreed that poor antibiotic use contributes to drug ineffectiveness, indicating strong awareness of the problem (\u003cstrong\u003eTable 4\u003c/strong\u003e). Overall, 50.6% of participants demonstrated poor practices regarding antibiotic use, while 49.4% demonstrated good practices (\u003cstrong\u003eFigure 1c\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Assessment of appropriate antibiotics use practices\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"632\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1129%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 31.1129%;\"\u003e\n \u003cp\u003e\u003cem\u003eImmediate action when feeling unwell\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eBuy a drug from Pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e92 (39.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eGo to Hospital for test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e134 (57.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eBorrow antibiotic from a friend or family member\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e7 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 31.1129%;\"\u003e\n \u003cp\u003e\u003cem\u003eImmediate recommended action when family/friend reports unwellness\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eTake them to the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e155\u0026nbsp;(66.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eBuy drug from pharmacy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e63\u0026nbsp;(27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eGive them remaining drug\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e15\u0026nbsp;(6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 31.1129%;\"\u003e\n \u003cp\u003e\u003cem\u003eMode of acquisition of antibiotics\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eLocal Pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e103 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eHospitals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e123 (52.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eFriends and Family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e7 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 31.1129%;\"\u003e\n \u003cp\u003e\u003cem\u003eSource of information on antibiotics acquired for treatment\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eHealthcare providers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e140 (60.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eInternet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e68 (29.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eFamily/friends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e18 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29.9867%;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3889%;\"\u003e\n \u003cp\u003e7 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 31.1129%;\"\u003e\n \u003cp\u003e\u003cem\u003eAssessment of poor antibiotic use contributing to drug ineffectiveness\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.1855%;\"\u003e\n \u003cp\u003eStrongly agree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18.5833%;\"\u003e\n \u003cp\u003e107 (45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.1855%;\"\u003e\n \u003cp\u003eAgree\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18.5833%;\"\u003e\n \u003cp\u003e95 (40.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.1855%;\"\u003e\n \u003cp\u003eDisagree\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18.5833%;\"\u003e\n \u003cp\u003e26 (11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.1855%;\"\u003e\n \u003cp\u003eStrongly disagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18.5833%;\"\u003e\n \u003cp\u003e5 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eCommonly used antibiotics by study participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmoxicillin predominated, reported by 153 (65.7%) of participants, followed by metronidazole 21 (9.0%), other agents 22 (9.4%), penicillin 18 (7.7%), ciprofloxacin 16 (6.9%), and erythromycin 3 (1.3%). This pattern depicts a heavy reliance on a single, widely available broad-spectrum agent likely reflects amoxicillin\u0026rsquo;s affordability, accessibility and role as a common first-line empirical choice, and may also signal frequent self-treatment or non-targeted prescribing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with inadequate knowledge towards antibiotics use among tertiary students\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the univariate analysis, female compared to male (cOR; 0.98, 95% CI; 0.53-1.83, \u003cem\u003ep\u003c/em\u003e=0.959), age bracket 25\u0026ndash;30 compared to 18\u0026ndash;24 (cOR; 0.37, 95% CI; 0.05-2.95, \u003cem\u003ep\u003c/em\u003e=0.365) and being Muslim compared to Christian (cOR 0.25, 95% CI; 0.03-1.93, \u003cem\u003ep\u003c/em\u003e=0.183) showed reduced and no significant likelihood of inadequate knowledge towards antibiotics use. By level of study, level 200 students showed trend toward reduced likelihood (cOR 0.43, 95% CI;0.18-1.05, \u003cem\u003ep\u003c/em\u003e=0.064) and level 300 students had markedly lower likelihood (cOR; 0.11, 95% CI; 0.04-0.32, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). Again, the level 400 students had a reduced likelihood of having inadequate knowledge towards antibiotics use compared to level 100 students (cOR; 0.13, 95% CI; 0.05-0.34, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). Among programs, physiotherapy students showed higher likelihood of having inadequate knowledge towards antibiotics use (cOR 4.46, 95% CI; 1.14\u0026ndash;17.41, \u003cem\u003ep\u003c/em\u003e=0.032) compared to Medical Imaging students. Bad practice compared to good practice (cOR; 0.60, 95% CI; 0.32-1.12, \u003cem\u003ep\u003c/em\u003e=0.109) and negative attitude compared to positive attitude (cOR; 0.83, 95% CI; 0.44-1.58, \u003cem\u003ep\u003c/em\u003e=0.568) were not associated with the likelihood of having inadequate knowledge towards antibiotics use.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAfter adjustment, the academic-level gradient remained the only robust independent predictor of having inadequate knowledge towards antibiotics use; compared with level 100 students, level 200 students (aOR; 0.32, 95% CI; 0.12\u0026ndash;0.87, \u003cem\u003ep\u003c/em\u003e=0.025), 300-level (aOR; 0.09, 95% CI; 0.03\u0026ndash;0.27, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001) and level 400 students (aOR; 0.12, 95% CI; 0.04\u0026ndash;0.34, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001) had significantly lower odds of inadequate knowledge. The crude excess risk seen in physiotherapy was diminished and non-significant after adjustment (aOR; 3.44, 95% CI; 0.78-15.29, \u003cem\u003ep\u003c/em\u003e=0.104).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable:\u003c/strong\u003e \u003cstrong\u003eFactors associated with inadequate knowledge towards antibiotics use among tertiary students\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"660\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 426px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInadequate Knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eMale*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.98(0.53-1.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.959\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAge (years)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e18-24*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e25-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.37(0.05-2.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.365\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eReligion\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eChristians*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eMuslims\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.25(0.03-1.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eLevel of Study\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e100*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.43(0.18-1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.32(0.12-0.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.025\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.11(0.04-0.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.09(0.03-0.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.13(0.05-0.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.12(0.04-0.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eProgram of Study\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eMedical Imaging*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eMedical Laboratory Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.81(0.24-2.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.723\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.70(0.19-2.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eMidwifery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.56(0.39-6.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.13(0.25-5.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.874\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.38(0.08-1.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.23(0.04-1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003ePhysiotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e4.46(1.14-17.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.032\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3.44(0.78-15.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePractice\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eBad*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.60(0.32-1.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAttitude\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003eNegative*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 234px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.83(0.44-1.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with negative attitude\u003c/strong\u003e \u003cstrong\u003etowards antibiotics use among tertiary students\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the univariate analysis, most sociodemographic factors were not associated with the likelihood of having negative attitude toward antibiotic use. Although not statistically significant, being Muslims compared to Christians (cOR; 1.60, 95% CI; 0.53\u0026ndash;4.78, \u003cem\u003ep\u003c/em\u003e=0.403) was associated with an increased chance of having a negative attitude towards antibiotics use. Female students (cOR: 0.74; 95% CI: 0.43\u0026ndash;1.30; p = 0.296), compared to their male counterparts, and students aged 25\u0026ndash;30 years (cOR: 0.88; 95% CI: 0.22\u0026ndash;3.50; p = 0.857), compared to those aged 18\u0026ndash;24 years, demonstrated a reduced but statistically insignificant likelihood of having a negative attitude towards antibiotic use. Neither level of study nor program of study showed significant crude associations with negative attitudes toward antibiotic use. The only strong crude predictor was practice: respondents who demonstrated good antibiotic use practices had significantly lower odds of exhibiting a negative attitude compared to those with poor practices (cOR: 0.17; 95% CI: 0.09\u0026ndash;0.33; p \u0026lt; 0.001). In contrast, adequate knowledge of antibiotic use was not significantly associated with attitude (cOR: 0.83; 95% CI: 0.44\u0026ndash;1.58; p = 0.568).\u003c/p\u003e\n\u003cp\u003eAfter adjusting for possible confounders in the multivariate analysis, good practice towards antibiotics use was the sole independent predictor of negative attitude towards antibiotics use, with participants reporting good practice having substantially lower adjusted odds of a negative attitude (aOR; 0.17, 95% CI; 0.09\u0026ndash;0.33, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). Adjusted estimates for female (aOR; 1.02, 95% CI; 0.56\u0026ndash;1.88, \u003cem\u003ep\u003c/em\u003e=0.946) and age 25\u0026ndash;30 (aOR; 0.73, 95% CI; 0.17\u0026ndash;3.18, \u003cem\u003ep\u003c/em\u003e=0.674) were non-significant, and other covariates did not show independent effects.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable:\u003c/strong\u003e \u003cstrong\u003eFactors associated with negative attitude\u003c/strong\u003e \u003cstrong\u003etowards antibiotics use among tertiary students\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"636\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 408px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative Attitude\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMale*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.74(0.43-1.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.02(0.56-1.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.946\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e18-24*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e25-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.88(0.22-3.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.73(0.17-3.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.674\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eChristians*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMuslims\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.60(0.53-4.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e100*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.93(0.37-2.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.875\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.84(0.34-2.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.96(0.40-2.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.915\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProgram of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMedical Imaging*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMedical Laboratory Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00(0.35-2.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026gt;0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMidwifery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.06(0.30-3.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.930\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.73(0.22-2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003ePhysiotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.13(0.31-4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eBad*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.17(0.09-0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.17(0.09-0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eInadequate*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 228px;\"\u003e\n \u003cp\u003eAdequate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.83(0.44-1.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with bad practices\u003c/strong\u003e \u003cstrong\u003etowards antibiotics use among tertiary students\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn univariate binary logistic models, female students had significantly lower odds of having bad antibiotic practices than males (cOR; 0.44, 95% CI; 0.26\u0026ndash;0.75, \u003cem\u003ep\u003c/em\u003e = 0.003). Students with a positive attitude toward antibiotics use were much less likely to report bad practices compared to negative attitude (cOR; 0.17, 95% CI; 0.09\u0026ndash;0.33, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001). Age, religious affiliation, level of study, program of study, and knowledge level were all not associated with the likelihood of having bad practices towards antibiotics use.\u003c/p\u003e\n\u003cp\u003eAfter adjusting for other covariates for confounders, females compared to males (aOR; 0.44, 95% CI; 0.25\u0026ndash;0.78, \u003cem\u003ep\u003c/em\u003e=0.005) and having positive attitude toward antibiotics use were (aOR; 0.17, 95% CI; 0.09\u0026ndash;0.33, \u003cem\u003ep\u003c/em\u003e\u0026lt; 0.001) remained strong and statistically significant with reduced odds of having bad practices towards antibiotics use. Other factors like age, religion, level, program, and knowledge did not show independent effects.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable:\u003c/strong\u003e \u003cstrong\u003eFactors associated with bad practices\u003c/strong\u003e \u003cstrong\u003etowards antibiotics use among tertiary students\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"672\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 424px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBad practices\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMale*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.44(0.26-0.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.44(0.25-0.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e18-24*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e25-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.49(0.41-5.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.548\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligious Affiliation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eChristians\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMuslims\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.32(0.44-3.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e100*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.89(0.78-4.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.28(0.54-3.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.570\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.67(0.74-3.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProgram of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMedical Imaging*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMedical Laboratory Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.71(0.63-4.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.293\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMidwifery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.66(0.19-2.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.89(0.29-2.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.831\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003ePhysiotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.35(0.40-4.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eInadequate*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eAdequate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.60(0.32-1.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003eNegative*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 248px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.17(0.09-0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.17(0.09-0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe inappropriate use of antibiotics is a major contributor to antimicrobial resistance, a growing public health threat in low-and middle-income countries. Assessing the level of knowledge, attitude and practices towards appropriate antimicrobial use will serve as a great resource in the fight against AMR. In this current study, we assessed the knowledge, attitudes and practices of antibiotic use among tertiary students in a Ghanaian tertiary institution and found that knowledge was generally adequate but key gaps remained. Practices were mixed as 57.5% seek hospital testing but 39.5% buy from pharmacies without tests, with 6.5% sharing leftover antibiotics. Overall, 77.3% had adequate knowledge, with 67.4% also having a positive attitude towards antibiotic use. Slightly above half of them (50.6%) also had poor practices towards appropriate antibiotics use with amoxicillin being the most used (65.7%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur findings revealed that a significant proportion of students (74.2%) had received formal education on appropriate antibiotic use with 78.1% of the training coming from the university. This indicates that universities are the main training source of appropriate antibiotic use for the participants and are good platforms for curricular interventions and stewardship integration. Similarly, Sefah (2022) reported that 79.4% of healthcare students surveyed had not received any training on antibiotics before entering university, highlighting the fact that their primary exposure to antibiotic knowledge and stewardship occurred during university education.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAlthough the overall knowledge of antibiotic use in this study was encouraging, important gaps persist. Using an 80% cutoff, 77.3% of participants demonstrated adequate knowledge; however, 13.3% still believed that antibiotics are effective against viruses, and 24.9% were uncertain. Additionally, 44.2% thought that \u0026ldquo;all antibiotics are safe,\u0026rdquo; highlighting conceptual misunderstandings despite formal training. Comparable results have been reported among Polish medical students, where 3% and 6% continued to believe antibiotics could treat viral infections such as influenza and the common cold, and misconceptions regarding resistance and safety remained (Sobierajski et al., 2021). Therefore, integrating targeted modules on antibiotic usage, safety, and resistance into educational curricula is essential to address these gaps and promote responsible antibiotic use. Similarly, Owusu-Ofori (2021)\u0026nbsp;observed that while 94.1% of healthcare students correctly identified that antibiotics treat bacterial infections, only 66.9% recognized that antibiotics are ineffective against viral infections meaning 33.1% held the misconception that antibiotics can cure viruses. This parallel misperception underscores that even with generally good knowledge levels, substantial gaps in understanding antibiotic indications and safety endure, reinforcing the need for targeted curriculum modules on antibiotic usage, adverse effects, and safety across educational institutions.\u003c/p\u003e\n\u003cp\u003eAcademic level was significantly associated with reduced odds of inadequate knowledge regarding antibiotic use. Multivariate analysis revealed progressively lower adjusted odds in 200-level (aOR: 0.32), 300-level (aOR: 0.09), and 400-level students (aOR: 0.12) compared to those in 100-level, with all associations reaching statistical significance (p \u0026le; 0.025). These findings suggest that academic progression, not program of study, drives knowledge in appropriate antibiotics use, therefore interventions should prioritize early (first year) students. A relevant comparison comes from who investigated healthcare students\u0026rsquo; antibiotic knowledge in Ghana. Their multivariable logistic regression showed that fifth-year students were approximately six times more likely to have good overall knowledge of antibiotics compared to fourth-year students (a\u003cem\u003eOR\u003c/em\u003e = 5.84; \u003cem\u003ep\u003c/em\u003e = 0.001) (Sefah et al., 2022b). This mirrors our finding of progressive knowledge gains across academic years, reinforcing that year of study plays a significant role in antibiotic literacy.\u003c/p\u003e\n\u003cp\u003eWhile knowledge is crucial, attitudes also tend to play a significant role in shaping patterns of antibiotic use. Majority of the participants (67.4%) had positive attitude with 87.1% also reporting taking antibiotics only after lab confirmation. Majority (51.1%) also acknowledged that prescribed antibiotics are not always effective. These findings contrast with results from healthcare student surveys in other contexts. Sefah\u0026rsquo;s work in Ghana reported that most students obtain antibiotics via a medical prescription (89.4%) but also documented substantial variation in knowledge and access-related behaviors across cohorts, with differences linked to year and course of study (Sefah et al., 2022b). Collectively, these findings suggest that while baseline attitudes are favorable in certain areas, they present opportunities that can be strengthened through stewardship training. When compared with the systematic review and meta-analysis by Atalay \u0026amp; Abebe Gelaw, (2024), the contrast becomes more pronounced. Their pooled analysis across 28 studies in Africa found that only 46.93% of participants exhibited positive attitudes toward antimicrobial resistance (AMR), with tertiary students showing the highest prevalence at 55.81% (Atalay \u0026amp; Abebe Gelaw, 2024). This is notably lower than the 67.4% positive attitude observed in the current study, suggesting that the surveyed population may have a relatively more favorable disposition toward responsible antibiotic use.\u003c/p\u003e\n\u003cp\u003eDespite the generally positive attitudes toward antibiotic use, problematic behaviors persist among tertiary students. In the present study, 46.4% reported discontinuing antibiotics once symptoms improved, and only 9.9% consistently adhered to prescribed antibiotic regimens. Comparable findings emerge from a survey of university students in Thailand (across both health and non-health fields), where a striking 65% reported discontinuing antibiotic treatment when they felt better, despite many also following doctor\u0026rsquo;s instructions in other respects (Precha et al., 2024).\u003c/p\u003e\n\u003cp\u003eGood practice was the only independent predictor of reduced odds of having a negative attitude (aOR: 0.17; p \u0026lt; 0.001), underscoring that strengthening concrete behaviors may help mitigate negative attitudes. These findings suggest that interventions should integrate behavioral skill-building with attitudinal education to effectively promote appropriate antibiotic use. This aligns with findings from a multicenter cross-sectional study in Saudi Arabia, where higher knowledge was significantly associated with improved practices and more positive attitudes toward antibiotic use (\u0026chi;\u0026sup2;, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001; and a positive moderate correlation, r = 0.406, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001) (Shrestha \u0026amp; Rajbhandari, 2018). These findings reinforce that enhancing concrete behaviors through knowledge-driven skill development and can substantially shift attitudes, underscoring the need for integrated interventions that fuse practical competency with attitude transformation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMixed but concerning practices were also observed in this current study as majority of the participants (50.6%) were classified as having poor practice towards appropriate antibiotics use. Comparable findings have been documented across different countries. Study conducted in Nigerian reported that while only 29.8% of undergraduates had good practice, 26.5% exhibited poor practice and 67.0% demonstrated merely fair practice, with significant correlations between poor knowledge and poor practice (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.037) (Onukansi et al., 2025). In Bangladesh, among university students during the COVID-19 era, 40.4% of 18\u0026ndash;21-year-olds were categorized as having poor antibiotic practices (Wahab et al., 2023). In Ghana, a 2012 study among tertiary students in Accra revealed that 46% failed to complete the full antibiotic course, and 49% had poor knowledge about the consequences of irrational use of antibiotics (Donkor et al., 2012). Together, these studies suggest that poor antibiotic practice particularly non-adherence to prescribed regimens and self-medication, is a widespread phenomenon among university students globally. These disparities likely stem from gaps in health literacy, differing access to credible prescribing information, and insufficient emphasis on antibiotic stewardship in curricula and public health messaging. Hence, integrating tailored behavioral interventions such as simulated case-based prescribing, reminders for course completion, and improved health education into university programs could help mitigate these persistent gaps.\u003c/p\u003e\n\u003cp\u003eAgain, more than half of the participants (57.5%) reported that they would go to the hospital for testing when they are unwell, while 39.5% buy antibiotics from the pharmacy without testing with 6.5% giving leftover drugs to others. These findings imply that while formal care-seeking is common, self-medication and sharing remain important misuse drivers which need both enforcement and education. In a study conducted among health science students in Ghana, Nyarko (2025) found that self-medication with antimicrobial drugs was prevalent, with 44.67% of respondents reporting use without prescription and 51.33% having done so within the past year (Nyarko et al., 2025). Ampicillin was the most used non-prescription antibiotic, typically obtained from pharmacies (52.33%). These practices reflect a pattern of informal antibiotic use that bypasses diagnostic confirmation, contributing to inappropriate consumption and potential antimicrobial resistance.\u003c/p\u003e\n\u003cp\u003eWith respect to participants\u0026rsquo; sources and information on antibiotics for treatment, antibiotics mainly acquired from the hospitals (52.8%) and local pharmacies (44.2%) were the major sources for acquiring antibiotics with their primary information source being healthcare providers (60.1%), and the internet (29.2%) implying that pharmacies are a key intervention point to enforce prescription-only dispensing, also healthcare providers and online channels can be used for stewardship messaging. In a meta-analysis of self-medication practices in Ghana, Opoku (2023) reported that pharmacies were consistently identified as a major source of antibiotics, particularly in urban settings where access to drug outlets is widespread. This supports the assertion that pharmacies represent a critical intervention point for enforcing prescription-only policies.\u003c/p\u003e\n\u003cp\u003eAgain, being a female (aOR 0.44, \u003cem\u003ep\u003c/em\u003e=0.005) coupled with having a positive attitude towards appropriate antibiotics use (aOR 0.17, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001) remained independent predictors of lower odds of bad practices indicating that male students should be targeted with tailored behavior-change programs and strengthening attitudes among tertiary students can translate into better practices. In a comparative analysis of pharmacy and non-pharmacy students at the University of Ghana, Amponsah (2022) reported that female students were more likely to engage in self-medication than males, yet they also demonstrated greater caution and ambivalence toward the practice. Among pharmacy students, 61.7% of females self-medicated compared to 49.4% of males, while among non-pharmacy students, 52.6% of females self-medicated versus 48.8% of males. Despite these rates, the study found that a substantial proportion of students, 36.8% of pharmacy and 27.6% of non-pharmacy exhibited ambivalent attitudes toward self-medication, suggesting that attitudes may mediate the relationship between gender and practice (Amponsah et al., 2022).\u003c/p\u003e\n\u003cp\u003eAmoxicillin dominated the commonly used antibiotics among the tertiary students (65.7%) followed by metronidazole (9.0%), ciprofloxacin (6.9%), penicillin (7.7%), and erythromycin (1.3%) and this clearly show that there is a heavy reliance on a single broad-spectrum agent raising resistance concerns therefore emphasis should be placed on guideline-based empirical therapy and local resistance surveillance. When compared with the systematic review and meta-analysis by Belachew (2021) the trend appears consistent across Sub-Saharan Africa. It was reported by Belachew (2021) that amoxicillin (26.5%) and co-trimoxazole (19.8%) were the most frequently dispensed antibiotics without prescription across community drug retail outlets (CDROs) in the region. Their findings revealed that upper respiratory tract infections and acute diarrhea often viral and self-limiting were the leading reasons for antibiotic requests, with amoxicillin being the preferred agent despite its broad-spectrum nature Belachew (2021). Conversely, Nyarko (2025) also found that ampicillin was the most used non-prescription antibiotic, typically obtained from pharmacies in their study conducted among health science students in Ghana (Nyarko et al., 2025). This widespread use, often without diagnostic confirmation, contributes to inappropriate consumption and accelerates resistance development\u003c/p\u003e\n\u003cp\u003eWhile the findings provide valuable insights, these limitations must be considered. Our sample (n = 233) is smaller than the conventional target for \u0026plusmn;5% precision in a population of about 2,000, which reduced the precision of proportion estimates (achieved ME \u0026asymp; \u0026plusmn;6.00%). Even though we reported confidence intervals where appropriate, and used adjusted regression models to improve efficiency and reduce bias to show the robustness of our findings, future studies should recruit a large sample size to have a true representation of the general population. Again, the sample skewed toward one program and young students may also affect our results and may not be a true representation of the general population. Future research should also evaluate the impact of early curricular stewardship interventions and pharmacy enforcement on knowledge, attitudes and practices over time (pre-post or cohort studies).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe recommend immediate integration of antibiotic stewardship into the undergraduate curriculum through mandatory, competency-based modules that combine targeted teaching with case-based exercises to translate knowledge into practice, aimed specifically at first-year students and students who exhibit higher odds of poor practice. These educational efforts should be reinforced by regular multidisciplinary workshops and student-led peer education, while campus policies that limit nonprescription access to antibiotics developed in collaboration with university health services, pharmacies, and the Ministry of Health will help reduce self-medication. Progress should be tracked using KAP indicators and rates of nonprescription acquisition, and these data should be used to refine interventions. Additionally, longitudinal and qualitative studies are needed to understand barriers to sustained behavior change and to evaluate the long-term impact of educational initiatives.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this cohort of tertiary health students, knowledge of antibiotic use was generally adequate but important misconceptions persisted. Crucially, academic progression was the only robust independent predictor of knowledge, indicating that stewardship efforts should be introduced early in the curriculum. Again, despite generally positive attitudes and frequent reliance on hospitals or healthcare providers for antibiotics, half of the participants reported poor practices towards appropriate antibiotics use and heavy self-reported use of amoxicillin, underscoring the need for combined educational, policy and surveillance interventions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Committee on Human Research, Publications and Ethics (CHRPE/AP/207/24) of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, prior to the commencement of the study. Written informed consent was obtained from all participants before enrollment. To maintain confidentiality and protect participants\u0026rsquo; identities, unique identification numbers were used instead of names throughout data collection and analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKinako Denis Elia Dazangapai conceptualized and conducted the study, collected the data, and together with Michael Nkrumah-Appau and Richard Owusu Ansah analyzed the data. Alex Owusu-Ofori supervised the study and critically revised the manuscript for important intellectual content. Eric Darko, Barikisu Ekua Seidu Dawuda, Beatrice Nyantakyiwaa, Richard Larbi, James Opoku Frimpong, and Raymond Xornam Sevor contributed to the literature review, drafting, and editing of the manuscript. All authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDual Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis manuscript is original and is not under consideration elsewhere, nor has it been previously published in whole or in part elsewhere, in any language. All sources are appropriately cited.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePermission to Use Third‑Party Material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll figures, tables, and text excerpts reproduced from other sources are accompanied by full citations. Where necessary, permission has been obtained from copyright holders and is available upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData and materials for the study are available upon request from the corresponding authors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAmponsah, S. K., Odamtten, G., Adams, I., \u0026amp; Kretchy, I. A. (2022). A comparative analysis of pattern and attitude towards self-medication among pharmacy and non-pharmacy students in University of Ghana. \u003cem\u003ePan African Medical Journal\u003c/em\u003e, \u003cem\u003e41\u003c/em\u003e. https://doi.org/10.11604/pamj.2022.41.254.31013\u003c/li\u003e\n\u003cli\u003eAppiah, B., Anum-Hagin, D., Gyansa-Luterrodt, M., Samman, E., Agyeman, F. K. 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Exploring the knowledge, practices \u0026amp; determinants of antibiotic self-medication among bangladeshi university students in the era of COVID-19: A cross-sectional study. \u003cem\u003eHeliyon\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(9). https://doi.org/10.1016/j.heliyon.2023.e19923\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"antibiotics, knowledge, resistance, attitude, self-medication","lastPublishedDoi":"10.21203/rs.3.rs-7703640/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7703640/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e\u003cp\u003eAntibiotic misuse is a growing global concern as it exacerbates antimicrobial resistance (AMR) and in Ghana, antibiotic misuse persists. University students in the Allied Health Sciences are uniquely positioned to influence patterns of antibiotic use, both as practitioners and educators. The aim of this study was to investigate the knowledge and awareness of appropriate antibiotic use among university students.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted among undergraduate students of the Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, from May\u0026ndash;August 2024. Using simple random sampling, 233 students were enrolled across five health programs. Data on knowledge, attitudes, and practices (KAP) regarding antibiotic use were collected via a structured, pretested questionnaire. Scores were categorized using an 80% threshold. Logistic regression model was computed to identify predictors of inadequate knowledge, negative attitude, and poor practices towards antibiotics use.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOut of the 233 participants, 58.8% were female and 95.7% aged 18\u0026ndash;24 years. Overall, 77.3% demonstrated adequate knowledge, 67.4% positive attitudes, and 49.4% good practices toward antibiotic use. Misconceptions persisted, with 13.3% believing antibiotics treat viral infections and 44.2% considering all antibiotics safe. Academic level was the strongest independent predictor of knowledge; compared with level 100, students in higher levels had significantly reduced odds of inadequate knowledge (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Positive attitude (aOR; 0.17) and female gender (aOR; 0.44) independently predicted good practices, while good practice (aOR; 0.17) strongly predicted negative attitudes (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) with reduced odds. Amoxicillin was the most commonly reported antibiotic (65.7%).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe study revealed that although most allied health sciences students possess some knowledge of appropriate antibiotic use, inappropriate practices such as self-medication and limited laboratory testing prior to antibiotic administration, persist. The findings also reveal critical gaps in knowledge, attitudes, and practices among such students regarding antibiotic use. Addressing these issues should be prioritized as an antimicrobial stewardship strategy as these students are crucial, tentative frontliners in healthcare administration in the country.\u003c/p\u003e","manuscriptTitle":"Knowledge, Attitudes and Practices of Antibiotic Use Among Students in A Ghanaian Tertiary Institution","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-10 15:36:58","doi":"10.21203/rs.3.rs-7703640/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-19T09:27:30+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-16T19:02:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-13T19:23:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155972706767283707562340483550001428877","date":"2025-11-04T22:25:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"324930117432984314301165562947488369536","date":"2025-11-03T15:47:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"74917203964948433917211823090137278446","date":"2025-10-29T19:55:36+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-28T11:19:29+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-19T12:01:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"86814869520752892254380842653432883071","date":"2025-10-19T04:26:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282960076740670537805411014764430163901","date":"2025-10-13T11:39:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-28T08:22:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-25T16:02:06+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-25T10:21:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-25T10:20:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-09-24T12:21:36+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5c21dd1a-50be-4375-af29-252835279a80","owner":[],"postedDate":"October 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-26T16:03:23+00:00","versionOfRecord":{"articleIdentity":"rs-7703640","link":"https://doi.org/10.1186/s12982-026-01350-1","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2026-01-19 15:57:47","publishedOnDateReadable":"January 19th, 2026"},"versionCreatedAt":"2025-10-10 15:36:58","video":"","vorDoi":"10.1186/s12982-026-01350-1","vorDoiUrl":"https://doi.org/10.1186/s12982-026-01350-1","workflowStages":[]},"version":"v1","identity":"rs-7703640","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7703640","identity":"rs-7703640","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}