Journals / Journal of Medicine and Palliative Care / 2026 / Volume: 7 Issue: 4

Knowledge, attitudes, and practices regarding antibiotic use among adults at an infectious diseases clinic

Enes Dalmanoğlu(BALIKESİR ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-4425-5649
Berat Karaman(BALIKESİR ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0005-5357-0845
Pages
—
Publication Date
2026-08-15
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Education-focused interventions delivered at the point of care and continued stewardship are warranted and require prospective evaluation.

📌 3 Key Takeaways

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Objective & Hypothesis:Aims: To assess the knowledge, attitudes, and practices (KAP) regarding antibiotic use among adults attending an infectious diseases outpatient clinic and to identify the sociodemographic factors associated with knowledge.
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Key Findings & Data:Methods: This cross-sectional study enrolled 245 adults (aged 18 years or older) by consecutive sampling between 23 May and 5 June 2026.
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Conclusion & Impact:Education-focused interventions delivered at the point of care and continued stewardship are warranted and require prospective evaluation.
🔬Design:Survey & Empirical Study
📍Scope:2026 Verileri
⚙️Variables:Anti-bacterial agents · microbial drug resistance · self-medication

Abstract

Aims: To assess the knowledge, attitudes, and practices (KAP) regarding antibiotic use among adults attending an infectious diseases outpatient clinic and to identify the sociodemographic factors associated with knowledge. Methods: This cross-sectional study enrolled 245 adults (aged 18 years or older) by consecutive sampling between 23 May and 5 June 2026. A structured four-section questionnaire assessed sociodemographic characteristics, knowledge (12 true/false items; score 0-12), attitudes (10 five-point Likert items; score 10-50), and self-reported practices over the preceding 12 months. Internal consistency was assessed with the Kuder-Richardson 20 (KR-20) and Cronbach alpha coefficients. Non-parametric tests, Spearman correlation, and multiple linear regression were applied, and factors associated with recognising the population level nature of resistance were examined by binary logistic regression. Significance was set at p<0.05. Results: The mean knowledge score was 8.98±2.18 (74.8% of the maximum) and the mean attitude score was 43.35±5.49. The lowest proportions of correct answers concerned the population-level nature of resistance (33.5%) and the ineffectiveness of antibiotics against viral infections (51.0%). Non-prescription use was reported by 11.0% of respondents, and 29.4% stopped treatment early upon symptom relief. University education was the sole independent predictor of knowledge (B=0.91; p=0.016). Recognition that resistance is not confined to those who take antibiotics was independently associated with younger age (adjusted odds ratio [aOR] for 35-49 versus 18-34 years 0.36; 95% confidence interval [CI] 0.19-0.69) and city-centre residence (aOR 2.27; 95% CI 1.26-4.10), but not with education (aOR 1.10; 95% CI 0.50-2.41). The three domain scores were positively intercorrelated (all p<0.001). Conclusion: In this selected, predominantly university-educated outpatient sample, which is not representative of the general adult population, knowledge was generally adequate and attitudes were favourable, yet specific misconceptions and premature discontinuation persisted. The collective nature of resistance was poorly understood irrespective of educational attainment. Education-focused interventions delivered at the point of care and continued stewardship are warranted and require prospective evaluation.

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Cite This Article

Dalmanoğlu, E., Karaman, B. (2026). Knowledge, attitudes, and practices regarding antibiotic use among adults at an infectious diseases clinic. Journal of Medicine and Palliative Care, Volume: 7 Issue: 4. https://doi.org/10.47582/jompac.1971542

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References (38)

  1. Murray CJL, Ikuta KS, Sharara F, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022; 399(10325):629-655. doi:10.1016/S0140-6736(21)02724-0
  2. O'Neill J. Tackling drug-resistant infections globally: final report and recommendations. London: Review on Antimicrobial Resistance; 2016.
  3. World Health Organization. Global Action Plan on Antimicrobial Resistance. Geneva: World Health Organization; 2015.
  4. Klein EY, Van Boeckel TP, Martinez EM, et al. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc Natl Acad Sci U S A. 2018;115(15):E3463-E3470. doi:10.1073/pnas.1717295115
  5. Gönen M, Aksoy M, İşli F, et al. Assessment of quarter billion primary care prescriptions from a nationwide antimicrobial stewardship program. Sci Rep. 2021;11:14621. doi:10.1038/s41598-021-94308-z
  6. Gashaw T, Yadeta TA, Weldegebreal F, Demissie L, Jambo A, Assefa N. The global prevalence of antibiotic self-medication among the adult population: systematic review and meta-analysis. Syst Rev. 2025;14(1):49. doi:10.1186/s13643-025-02783-6
  7. Ahmed I, King R, Akter S, Akter R, Aggarwal VR. Determinants of antibiotic self-medication: a systematic review and meta-analysis. Res Social Adm Pharm. 2023;19(7):1007-1017. doi:10.1016/j.sapharm.2023.03.009
  8. World Health Organization. Antibiotic Resistance: Multi-Country Public Awareness Survey. Geneva: World Health Organization; 2015.
  9. Singh-Phulgenda S, Antoniou P, Wong DLF, Iwamoto K, Kandelaki K. Knowledge, attitudes and behaviors on antimicrobial resistance among general public across 14 member states in the WHO European region: results from a cross-sectional survey. Front Public Health. 2023;11: 1274818. doi:10.3389/fpubh.2023.1274818
  10. Gaygısız Ü, Lajunen T, Gaygısız E. Community use of antibiotics in Turkey: the role of knowledge, beliefs, attitudes, and health anxiety. Antibiotics (Basel). 2021;10(10):1171. doi:10.3390/antibiotics10101171
  11. Lajunen TJ, Sullman MJM, Baddal B, Tekeş B, Apostolou M. Antibiotics knowledge, attitudes and behaviours among the population living in Greece and Turkey. Antibiotics (Basel). 2023;12(8):1279. doi:10.3390/antibiotics12081279
  12. Oikonomou ME, Gkentzi D, Karatza A, Fouzas S, Vervenioti A, Dimitriou G. Parental knowledge, attitude, and practices on antibiotic use for childhood upper respiratory tract infections during COVID-19 pandemic in Greece. Antibiotics (Basel). 2021;10(7):802. doi:10.3390/antibiotics10070802
  13. Karuniawati H, Hassali MAA, Suryawati S, Ismail WI, Taufik T, Hossain MS. Assessment of knowledge, attitude, and practice of antibiotic use among the population of Boyolali, Indonesia: a cross-sectional study. Int J Environ Res Public Health. 2021;18(16):8258. doi:10.3390/ijerph18168258
  14. Higuita-Gutiérrez LF, Roncancio Villamil GE, Jiménez Quiceno JN. Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study. BMC Public Health. 2020;20(1):1861. doi:10.1186/s12889-020-09971-0
  15. Ling Oh A, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A. Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. J Infect Dev Ctries. 2011;5(5):338-347. doi:10.3855/jidc.1502
  16. Sanchez GV, Fleming-Dutra KE, Roberts RM, Hicks LA. Core elements of outpatient antibiotic stewardship. MMWR Recomm Rep. 2016;65(6):1-12. doi:10.15585/mmwr.rr6506a1
  17. McCullough AR, Parekh S, Rathbone J, Del Mar CB, Hoffmann TC. A systematic review of the public's knowledge and beliefs about antibiotic resistance. J Antimicrob Chemother. 2016;71(1):27-33. doi:10.1093/jac/dkv310
  18. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596): 1453-1457. doi:10.1016/S0140-6736(07)61602-X
  19. Cochran WG. Sampling Techniques. 3rd ed. New York: John Wiley & Sons; 1977.
  20. Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-497. doi:10.1002/nur.20147
  21. Foster KR, Grundmann H. Do we need to put society first? The potential for tragedy in antimicrobial resistance. PLoS Med. 2006;3(2):e29. doi:10.1371/journal.pmed.0030029
  22. Sampedro Restrepo M, González Gaviria M, Arango Bolaños S, Higuita-Gutiérrez LF. Knowledge, attitude and practice regarding antibacterial and their resistance in Medellín-Colombia: a cross-sectional study. Antibiotics (Basel). 2023;12(7):1101. doi:10.3390/antibiotics12071101
  23. Ocan M, Obuku EA, Bwanga F, et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health. 2015; 15(1):742. doi:10.1186/s12889-015-2109-3
  24. Alkhuraisi LS, Mirghani H, Al Qahtani MM, et al. Knowledge, attitude, and practice of antibiotic resistance among general population in Saudi Arabia: a cross-sectional study. Cureus. 2023;15(12):e51053. doi:10.7759/cureus.51053
  25. Yin X, Gong Y, Sun N, et al. Prevalence of inappropriate use behaviors of antibiotics and related factors among Chinese antibiotic users: an online cross-sectional survey. BMC Infect Dis. 2022;22(1):689. doi:10.1186/s12879-022-07671-1
  26. Mengesha Y, Manaye B, Moges G. Assessment of public awareness, attitude, and practice regarding antibiotic resistance in Kemissie Town, Northeast Ethiopia: community-based cross-sectional study. Infect Drug Resist. 2020;13:3783-3789. doi:10.2147/IDR.S280036
  27. Rathish D, Wickramasinghe ND. Prevalence, associated factors and reasons for antibiotic self-medication among dwellers in Anuradhapura: a community-based study. Int J Clin Pharm. 2020;42(4):1139-1144. doi:10.1007/s11096-020-01065-6
  28. Ateshim Y, Bereket B, Major F, et al. Prevalence of self-medication with antibiotics and associated factors in the community of Asmara, Eritrea: a descriptive cross sectional survey. BMC Public Health. 2019;19(1):726. doi:10.1186/s12889-019-7020-x
  29. Althubaiti A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc. 2016;9:211-217. doi:10.2147/JMDH.S104807
  30. Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JGM, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006; 12(3):452-459. doi:10.3201/eid1203.050992
  31. Lescure D, Paget J, Schellevis F, van Dijk L. Determinants of self-medication with antibiotics in European and Anglo-Saxon countries: a systematic review of the literature. Front Public Health. 2018;6:370. doi:10.3389/fpubh.2018.00370
  32. Jairoun A, Hassan N, Ali A, Jairoun O, Shahwan M. Knowledge, attitude and practice of antibiotic use among university students: a cross sectional study in UAE. BMC Public Health. 2019;19(1):518. doi:10.1186/s12889-019-6878-y
  33. Huttner B, Goossens H, Verheij T, Harbarth S; CHAMP consortium. Characteristics and outcomes of public campaigns aimed at improving the use of antibiotics in outpatients in high-income countries. Lancet Infect Dis. 2010;10(1):17-31. doi:10.1016/S1473-3099(09)70305-6
  34. Widayati A, Suryawati S, de Crespigny C, Hiller JE. Knowledge and beliefs about antibiotics among people in Yogyakarta City Indonesia: a cross-sectional population-based survey. Antimicrob Resist Infect Control. 2012;1(1):38. doi:10.1186/2047-2994-1-38
  35. Hadi U, Duerink DO, Lestari ES, et al. Survey of antibiotic use of individuals visiting public healthcare facilities in Indonesia. Int J Infect Dis. 2008;12(6):622-629. doi:10.1016/j.ijid.2008.01.002
  36. Sun R, Yao T, Zhou X, Harbarth S, Lin L. Non-biomedical factors affecting antibiotic use in the community: a mixed-methods systematic review and meta-analysis. Clin Microbiol Infect. 2022;28(3):345-354. doi:10.1016/j.cmi.2021.10.017
  37. Torres NF, Chibi B, Middleton LE, Solomon VP, Mashamba-Thompson TP. Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review. Public Health. 2019;168:92-101. doi:10.1016/j.puhe.2018.11.018
  38. World Health Organization. Antimicrobial Resistance: Global Report on Surveillance. Geneva: World Health Organization; 2014.