Antibiotic self-medication among healthcare students in Pakistan: A dual-center cross-sectional study

Background Antibiotic self-medication is an emerging global health challenge, contributing significantly to antimicrobial resistance development. Healthcare students’ knowledge and practices are particularly crucial, given their future roles as medical professionals. Objectives This investigation sought to assess antibiotic self-medication patterns among Pakistani healthcare students by examining their knowledge, attitudes, and practices, while identifying contributing factors and prevalence rates. Methods A cross-sectional analysis was implemented at two Pakistani universities, involving 1340 undergraduate healthcare students selected through convenience sampling. Data were collected using a structured, validated questionnaire that evaluated sociodemographic factors as well as participants’ understanding, perspectives, and behaviors regarding antibiotic self-medication. Knowledge and attitude measurements were classified as poor/negative or good/positive. Statistical significance was set at p < 0.05. Results The study revealed that 68.8% of respondents practiced antibiotic self-medication. Despite 63.3% demonstrating adequate antibiotic knowledge, 53.4% exhibited negative self-medication attitudes. Knowledge distribution varied according to academic program and year of study. DPT students showed the highest self-medication frequency at 77.3%. Amoxicillin (56%) and Azithromycin (31.3%) emerged as predominant choices, primarily selected for convenience (77.5%) and respiratory symptoms (50.4%). Previous prescriptions significantly affected antibiotic selection. Analysis revealed a substantial correlation between knowledge levels and attitudes toward antibiotic usage (p < 0.001). Conclusion Despite adequate knowledge levels among participants, a concerning trend of negative attitudes toward antibiotic self-medication practices was observed. These findings emphasize the critical need for comprehensive educational interventions and strengthened regulatory frameworks to minimize inappropriate antibiotic use among healthcare students, which is essential for addressing the growing challenge of antimicrobial resistance, and to reduce inappropriate antibiotic use ensuring both patient safety and future professional performance.