Assessing awareness and attitudes among Middle Eastern and North African populations regarding antimicrobial drug resistance: a regional cross-sectional study

Antimicrobial resistance (AMR) is an escalating global health crisis, yet patterns of public understanding and antibiotic consumption in the Middle East and North Africa remain under-researched. This study aimed to evaluate the current landscape of AMR awareness, knowledge gaps, and self-medication practices among the general populations of seven Middle Eastern and North African nations. A large-scale, multicenter, cross-sectional study was conducted involving participants from Egypt, Palestine, Algeria, Sudan, Syria, Libya, and Jordan. Data were collected using an online, self-administered questionnaire and convenience sampling. Knowledge levels were quantified based on responses to standardized questions and categorized as poor, fair, or good. Statistical associations between demographic characteristics and self-medication practices were analyzed using SPSS. A total of 12,729 respondents completed the survey, of whom 74.6% were female. Although awareness was high—with 82.3% recognizing the term “antibiotic resistance”—conceptual understanding was lower. Less than half of the participants correctly identified that antibiotics are ineffective against flu-like viral illnesses. Good knowledge scores were achieved by only 42.6% of the cohort. Among the 28% of participants who reported recent antibiotic use, nearly one-third (29.3%) obtained the medication without a prescription. Demographic analysis revealed that females, urban residents, individuals aged 19–20 years, and those with higher education or medical backgrounds had significantly higher knowledge levels ( p < 0.001). Despite widespread recognition of the term “antibiotic resistance,” this study exposes profound gaps in public understanding in the Middle East and North Africa regarding appropriate antibiotic indications and the dangers of self-medication. The disconnect between terminology recognition and actual antibiotic-use behavior highlights an urgent need for targeted, culturally adapted public health campaigns and stricter regulatory enforcement to curb the spread of AMR in the region.