# Knowledge, Attitudes, and Practices of Antibiotic Use and Antimicrobial Resistance Among Medical Students in Southern Iraq

## TL;DR

This study examines how medical students in southern Iraq understand and use antibiotics, finding a gap between their knowledge and actual practices.

## Contribution

The study provides new insights into antibiotic use and AMR knowledge among Iraqi medical students, identifying a need for improved educational interventions.

## Key findings

- Knowledge scores improved with each academic year, but 75.9% of students still showed poor antibiotic use practices.
- Only 46.5% of sixth-year students demonstrated a positive attitude toward appropriate antibiotic use.
- A significant gap exists between students' knowledge of antibiotics and their actual prescribing practices.

## Abstract

Background

Antimicrobial resistance (AMR) is a growing global public health threat, largely driven by inappropriate antibiotic use. Low- and middle-income countries are disproportionately affected, yet data on AMR-related knowledge and practices among medical students in Iraq remain limited. Evaluating medical students’ knowledge, attitudes, and practices regarding antibiotic use is essential for informing effective educational and stewardship interventions.

Methodology

This descriptive cross-sectional study was conducted among medical students at the University of Basrah during the 2024-2025 academic year using a questionnaire developed after a literature review of previously published KAP studies. A stratified sampling method was applied. Data were analyzed using descriptive statistics, Chi-square tests, independent samples t-tests, ANOVA, and Kruskal-Wallis tests with IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, New York, United States).

Results

A total of 600 students completed the survey, of which 51.7% were female. Knowledge scores improved significantly with each academic year (p<0.001), yet 75.9% showed poor practice, while the total proportion of students that demonstrated poor knowledge was 51.0%. Findings also indicate a general trend towards a more positive attitude, from 20.9% of second-year medical students demonstrating a positive attitude to 46.5% of sixth-year students. Interestingly, a gap was noted between students’ knowledge levels and actual antibiotic use practices.

Conclusion

Despite the significant improvement in knowledge levels, poor practices persisted among medical students, highlighting the need for targeted interventions to raise awareness and improve practices among future prescribing physicians.