# Awareness of antimicrobial resistance and appropriate handling of antibiotics by the public in Saudi Arabia: A cross-sectional study using a quiz game

## TL;DR

A quiz game was used to assess and raise awareness about antimicrobial resistance among the public in Saudi Arabia, revealing average knowledge and factors linked to better understanding.

## Contribution

An innovative quiz game approach was used to both assess public AMR knowledge and indirectly raise awareness.

## Key findings

- Only 17.8% of participants had a health-related major, and the median AMR knowledge score was 6 out of 10.
- Participants with health-related majors and prior AMR knowledge scored significantly higher.
- The study recommends awareness campaigns to improve public understanding of AMR and antibiotic handling.

## Abstract

Public awareness of antimicrobial resistance (AMR) is essential to tackling this issue. Studies in Saudi Arabia have demonstrated insufficient AMR knowledge among the public. We aimed to indirectly raise awareness while simultaneously assessing the public's knowledge. We also assessed the factors associated with optimal knowledge and antibiotic handling.

We developed an online quiz game comprising 10 questions on AMR knowledge and antibiotic handling, recording each participant's score. We collected the responses from the Saudi public using a cross-sectional study design.

Of the 428 participants, 68.7% were females and 42.5% were aged between 41 and 65 years; 70.1% held undergraduate degrees. Only 17.8% had a health-related major. While 83.2% had heard of AMR, the median [interquartile range] AMR knowledge score was 6 [5–7] out of 10 points. Holding a health-related major and having prior knowledge of AMR were associated with higher scores (RR, 1.28 and 1.18; 95%CI, 1.13–1.44 and 1.03–1.35; P < 0.001 and P = 0.020, respectively).

The Saudi public demonstrated average knowledge of AMR. We recommend awareness-raising campaigns about AMR targeting the public.

We utilized an innovative approach by distributing an online questionnaire as a quiz game to fulfill two purposes: the assessment of knowledge and awareness-raising about AMR.

•Public awareness of antimicrobial resistance (AMR) is essential to tackle the issue.•We utilized a scored online quiz game to assess the knowledge of the public in Saudi Arabia on AMR.•The public in Saudi Arabia demonstrated an average AMR knowledge.•Holding a health-related major and having heard of AMR were significantly associated with higher scores.•AMR awareness-raising campaigns are recommended to spread knowledge on AMR and improve antibiotic handling by the public.

Public awareness of antimicrobial resistance (AMR) is essential to tackle the issue.

We utilized a scored online quiz game to assess the knowledge of the public in Saudi Arabia on AMR.

The public in Saudi Arabia demonstrated an average AMR knowledge.

Holding a health-related major and having heard of AMR were significantly associated with higher scores.

AMR awareness-raising campaigns are recommended to spread knowledge on AMR and improve antibiotic handling by the public.