Knowledge, attitudes, and practices on antibiotic use and antimicrobial resistance among graduating health care professionals at Debre Tabor University, Ethiopia: a cross-sectional study with implications for antimicrobial stewardship education.

Abstract

Background: Rational use of antimicrobials is a key strategy for preventing antimicrobial resistance (AMR) and relies primarily on the knowledge and practices of future health care professionals.

Objectives: To assess the knowledge, attitudes, and practices of graduating health care students regarding antibiotic use and AMR at Debre Tabor University.

Design: An institution-based cross-sectional study was employed.

Methods: The study was conducted from March to April 2025 among graduating students at the College of Health Sciences. A validated self-administered questionnaire was used to assess knowledge, attitude, and practice (KAP). Scores were categorized using previous studies and modified Bloom's cut-off criteria (⩾80% = good; <80% = poor). Data were analyzed using descriptive statistics, chi-square tests, pearson correlation, and logistic regression, with p-values < 0.05 considered statistically significant.

Results: Antibiotic use in the past year was reported by 75.2% of participants, with ciprofloxacin and amoxicillin being the most commonly used agents. Overall, 55.8% showed good knowledge, 41.3% had a positive attitude and 51.4% reported good practices. While awareness of AMR was high, only 32.5% correctly identified antimicrobial stewardship (AMS). A total of 68% of students purchased antibiotics without a prescription, and 69.9% discontinued treatment once symptoms improved. Significant differences in KAP across departments were observed (p < 0.005). Knowledge was positively correlated with attitude (r = 0.31, p = 0.001), and attitude with practice (r = 0.29, p = 0.002), whereas knowledge was not significantly associated with practice. Knowledge and Attitude levels were independent predictors of good attitude and practice, respectively. Additionally, birthplace, department of study, prior antibiotic use, AMR training, and family health background were associated with KAP outcomes, respectively.

Conclusion: The study showed that 55.8% of respondents had good knowledge, but attitudes (41.3%) and practices (51.4%) were lower, highlighting a clear knowledge-practice gap and the need for strengthened AMS training.