Assessment of Knowledge, Attitude, and Practice Toward Self-Medication with Antibiotics Among Students Belonging to Healthcare and Non-Healthcare Study Backgrounds

Antibiotics are vital pharmaceutical agents used primarily for the treatment of bacterial infections, operating either by directly killing bacteria (bactericidal) or inhibiting their growth (bacteriostatic) 1. Since their discovery, antibiotics have revolutionized medical care, enabling the effective treatment of infections that were once life-threatening. However, their widespread and often irrational use has led to a mounting global crisis — antimicrobial resistance (AMR), which threatens to undermine decades of progress in medicine 2. Self-medication with antibiotics (SMA) is one of the key contributors to this crisis. The World Health Organization (WHO) defines self-medication as the selection and use of medicines by individuals to treat self-recognized conditions or symptoms without professional supervision 3. Although responsible self-medication can ease the burden on healthcare systems by providing relief from minor ailments, inappropriate use — especially of antibiotics — can lead to misdiagnosis, adverse drug reactions, masking of serious conditions, and most significantly, the evolution of drug-resistant bacterial strains 4. In developing countries like India, the practice of SMA is alarmingly common, driven by factors such as over-the-counter (OTC) availability of antibiotics, lack of regulatory enforcement, low health literacy, time constraints, and economic limitations 5. The prevalence of antibiotic self-medication is particularly high among university students, including those studying in both medical and non-medical disciplines 6. Paradoxically, while healthcare students are expected to possess greater knowledge about the prudent use of antibiotics, numerous studies have shown that they too engage in SMA, often influenced by convenience, prior prescriptions, and peer behavior 7. The implications of this practice are severe. According to the WHO, antimicrobial resistance is projected to cause 10 million deaths annually by 2050 if left unchecked 8. Studies from Europe and Asia have highlighted disturbing trends, such as increasing resistance to carbapenems, third-generation cephalosporins, and fluoroquinolones among organisms like Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus 9. In the Indian context, resistance to first-line antibiotics is already affecting treatment efficacy for common infections such as typhoid, tuberculosis, and pneumonia 10. Given the critical role that education plays in shaping health behaviors, it becomes essential to assess and compare the knowledge, attitudes, and practices (KAP) related to antibiotic use among different student populations. Healthcare students, as future prescribers, must be equipped with sound knowledge and ethical practices to mitigate the threat of AMR. Likewise, educating non-healthcare students — who represent a large portion of the general public — is equally important, as they too influence drug consumption patterns and contribute to resistance trends 11. This study aims to assess the KAP toward antibiotic self-medication among healthcare and non-healthcare students in Guntur, Andhra Pradesh, with the broader goal of identifying knowledge gaps and behavioral patterns that could be addressed through targeted educational interventions and policy reforms. A cross-sectional survey using a structured questionnaire was employed, covering awareness of antibiotic function and resistance, sources of self-medication, frequency of use, and perception of associated risks. Understanding these patterns will provide evidence to inform institutional curricula, national antibiotic stewardship programs, and community awareness initiatives. Moreover, by drawing comparisons between student groups, this study provides a critical lens into how academic background influences rational medicine use, a fundamental component in the global fight against AMR.