Knowledge, Attitudes, and Practices of Antimicrobial Uses and Resistance Among Public University Students in Bangladesh

Figures & data

Table 1 Knowledge of Antibiotics, Their Uses, and Antibiotic Resistance in Biology-Background (n=92) and Non-Biology (n=113) University Students

Knowledge Question/Comment About Antibiotic Uses and Antibiotic Resistance	Student Category	Response Frequency, Number (%) ^a
		True	False	Uncertain	p value ^b
Antibiotics are effective for the treatment of bacterial infections	Biology	88 (95.7)	3 (3.3)	1 (1.1)	0.000
	Non-biology	75 (66.4)	10 (8.8)	28 (24.8)
Antibiotics are effective for the treatment of viral infections	Biology	26 (28.3)	62 (67.4)	4 (4.3)	0.000
	Non-biology	36 (31.9)	42 (37.2)	35 (31.0)
Antibiotics are effective for the treatment of both bacterial and viral infections	Biology	26 (28.3)	61 (66.3)	5 (5.4)	0.000
	Non-biology	36 (31.9)	35 (31.0)	42 (37.2)
Antibiotic resistance is the loss of activity of an antibiotic^▲	Biology	66 (71.7)	25 (27.2)	1 (1.1)	0.000
	Non-biology	89 (78.8)	7 (6.2)	14 (12.4)
Missing an antibiotic dose contributes to antibiotic resistance^▲	Biology	78 (84.8)	10 (10.9)	4 (4.3)	0.084
	Non-biology	87 (77.0)	10 (8.8)	15 (13.3)
Antibiotic resistance can be caused by the overuse of antibiotics	Biology	78 (84.8)	3 (3.3)	11 (12.0)	0.263
	Non-biology	90 (79.6)	10 (8.8)	13 (11.5)
Consumption of antibiotics without physician’s prescription can contribute to antibiotic resistance	Biology	88 (95.7)	2 (2.2)	2 (2.2)	0.180
	Non-biology	100 (88.5)	7 (6.2)	6 (5.3)

Notes: ^aRow percentage. ^bp-value was calculated using Chi-square statistic. ^▲With some missing values.

Table 2 Levels of Knowledge About Antibiotics, Their Uses, and Antibiotic Resistance

Knowledge	Number of Respondents	% of Respondents
Poor	70	34.1
Moderate	48	23.4
Good	87	42.4

Figure 1 Combined knowledge scores on antibiotic uses and antibiotic resistance.

Notes: The dotted bar represents the knowledge scores for biological-faculty students and the solid bar exhibit the same for non-biological students. The upward linear trend line indicates the students with biological background answered more questions correctly. The down-trend towards higher scores for non-biological students demonstrates their comparative lower level of understanding on the subject matter.

Table 3 Predictors of Knowledge About Antibiotics, Their Uses, and Antibiotic Resistance Based on Multivariate Regression Analysis

Knowledge	Crude		Adjusted
	OR (95% CI)	p value	OR (95% CI)	p value
Gender
Female	1		1
Male	1.69 (1.01, 2.83)	0.044	1.69 (0.99, 2.88)	0.052
Student Category
Non-biology	1		1
Biology	4.44 (2.57, 7.69)	<0.001	4.44 (2.56, 7.70)	<0.001

Table 4 Attitudes and Beliefs of Antibiotic Selections and Uses in Biology-Background (n=92) and Non-Biology (n=113) University Students

Question/Comment to Assess Attitudes and Beliefs of Antibiotic Selection and Uses	Student Category	Response Frequency, Number (%) ^a
		Agree	Disagree	Uncertain	p value ^b
Do you think antibiotic resistance is increasing? ^▲	Biology	90 (98.9)	0 (0)	1 (1.1)	0.019
	Non-biology	98 (89.1)	2 (1.8)	10 (9.1)
Do you think we should be more concerned regarding antibiotic consumption? ^▲	Biology	91 (98.9)	1 (1.1)	0 (0)	0.284
	Non-biology	108 (96.4)	1 (0.9)	3 (2.7)
Government should create more awareness of antibiotic resistance	Biology	90 (97.8)	1 (1.1)	1 (1.1)	0.522
	Non-biology	108 (95.6)	4 (3.5)	1 (0.9)
Enough knowledge should be generated to prevent antibiotic resistance^▲	Biology	84 (92.3)	3 (3.3)	4 (4.4)	0.518
	Non-biology	103 (91.2)	7 (6.2)	3 (2.7)
The uses of antibiotics in poultry and dairy industries should be strictly monitored^▲	Biology	86 (95.6)	2 (2.2)	2 (2.2)	0.109
	Non-biology	98 (87.5)	4 (3.6)	10 (9.0)
Do you think physicians often prescribe antibiotics unnecessarily? ^▲	Biology	39 (42.4)	37 (40.2)	16 (17.4)	0.253
	Non-biology	61 (54.0)	37 (32.8)	15 (13.3)

Notes: ^aRow percentage. ^bp-value was calculated using Chi-square statistic. ^▲With some missing values.

Table 5 Frequencies of Students Based on Their Everyday Practice of Taking Antibiotic

How Do You Intake Antibiotics	Responses of Students n (%)
	Biological Science, N=92	Non-Biological Science, N=113
1. Physician’s prescription	86 (93.47%)	104 (92%)
2. Self-medication	8 (8.7%)	13 (11.5%)
3. Suggested by friends/relatives	4 (4.3%)	17 (15%)
4. Suggested by pharmacists	14 (15.2%)	23 (20.3%)
5. According to previous prescription	10 (10.9%)	14 (12.4%)

Figure 2 Reasons for not completing the course of prescribed antibiotics.

Notes: Red bar indicates students of biological science faculty and green bar indicates students of non-biological science faculty. The X-axis enlisted different reasons of students for not completing the prescribed antibiotic courses. Y-axis shows the percentage of respondents.

Figure 3a Continue.

Figure 3b Questionnaire knowledge, attitude and practice about antibiotic use and antibiotic resistance among students of a public university of Bangladesh.

Table 6 Predictors of Self-Medication with Antibiotics Based on Multivariate Regression Analysis

Self-Medication	Crude		Adjusted
	OR (95% CI)	p value	OR (95% CI)	p value
Gender
Female	1		1
Male	2.00 (0.77, 5.18)	0.154	1.83 (0.69, 4.83)	0.225
Student Category
Non-biology	1		1
Biology	0.73 (0.29, 1.85)	0.511	0.62 (0.22, 1.78)	0.376
Knowledge about antibiotics
Poor	1		1
Moderate	0.14 (0.02, 1.19)	0.071	0.16 (0.02, 1.32)	0.089
Good	0.98 (0.38, 2.52)	0.968	1.11 (0.39, 3.20)	0.844