Knowledge, Attitudes, and Practices of adolescents regardingantibiotic use and resistance: A Qualitative study from adeveloping country
Main Article Content
Keywords
Adolescents, Antibiotic Use, Antimicrobial Resistance, Qualitative Study, Knowledge, Attitudes, and Practices,
Abstract
Background: Antimicrobial resistance (AMR) is a worldwide problem that impacts all aspects of society, including schoolchildren. This study explores the knowledge, attitudes, and practices of secondary school adolescents regarding antibiotic use and resistance. Methods: We used qualitative research methods with a focus group approach. Jordanian secondary school adolescents aged 16 to 18 from various schools were interviewed, and thematic analysis was carried out on the interview’ transcripts. Results: Secondary school adolescents (n= 48) from eight schools in different places participated in eight focus groups. Most participants (n=46) admitted not having heard of antibiotic resistance before the interview. Few students had a vague understanding or had heard the term mentioned in passing, often through the media or family members. Students frequently emphasized that common infections could be treated with antibiotics. A large proportion of the students reported taking antibiotics for self-diagnosed infections or based on advice from family members. Conclusions: The current study findings have revealed significant gaps in knowledge, attitude, and wrong practices about antibiotic resistance among secondary school students in developing countries like Jordan.
References
1. Masadeh MM, Alzoubi KH, Masadeh MM, Aburashed ZO. Metformin as a potential adjuvant antimicrobial agent against multidrug resistant bacteria. Clin Pharmacol 2021:83–90.
2. Masadeh M, Harun SN, Mukattash T, Alrabadi N. Parental Knowledge and Attitudes Towards Antibiotic Resistance in Children: A Review Article. Curr Pediatr Rev 2025.
3. Al Shikh H, Bani Hani S, Smiran R K. The Impact of Educational Intervention on Jordanian Parents’ Knowledge and Attitudes Regarding Children’s Antibiotic Use. Jordan Journal of Nursing Research 2024;3.
4. Wall S. Prevention of antibiotic resistance–an epidemiological scoping review to identify research categories and knowledge gaps. Glob Health Action 2019;12.
5. Kanan M, Ramadan M, Haif H, Abdullah B, Mubarak J, Ahmad W, Mari S, Hassan S, Eid R, Hasan M, Qahl M, Assiri A, Sultan M, Alrumaih F, Alenzi A. Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward. Antibiotics 2023;12.
6. Abdel-Qader DH, Albassam A, Ismael NS, El-Shara’ AA, Shehri A, Almutairi FS, Al-Harbi DM, Al Zahrani MM, Chen LC, Al Mazrouei N, Mohamed Ibrahim O. Awareness of Antibiotic Use and Resistance in Jordanian Community. J Prim Care Community Health 2020;11.
7. Songco A, Hudson JL, Fox E. A Cognitive Model of Pathological Worry in Children and Adolescents: A Systematic Review. Clin Child Fam Psychol Rev 2020;23:229–49.
8. Steinberg L. Cognitive and affective development in adolescence. Trends Cogn Sci 2005;9:69–74.
9. Masadeh M, Harun SN, Mukattash T, Alrabadi N. Parental Knowledge and Attitudes Towards Antibiotic Resistance in Children: A Review Article. Curr Pediatr Rev 2025.
10. Holstein BE, Andersen A, Krølner R, Due P, Hansen EH. Young adolescents’ use of medicine for headache: Sources of supply, availability and accessibility at home. Pharmacoepidemiol Drug Saf 2008;17:406–10.
11. Masadeh MM, Harun SN, Alrabadi N. Evaluating the Validity and Reliability of Questionnaires Measuring Knowledge, Attitudes, and Practices Towards Antibiotic Resistance Among Youths: A Systematic Review Protocol. Jordan Journal of Pharmaceutical Sciences 2024;17:362–70.
12. Hawking MKD, Lecky DM, Touboul Lundgren P, Aldigs E, Abdulmajed H, Ioannidou E, Paraskeva-Hadjichambi D, Khouri P, Gal M, Hadjichambis AC, Mappouras D, McNulty CAM. Attitudes and behaviours of adolescents towards antibiotics and self-care for respiratory tract infections: A qualitative study. BMJ Open 2017;7.
13. Holstein BE, Andersen A, Krølner R, Due P, Hansen EH. Young adolescents’ use of medicine for headache: Sources of supply, availability and accessibility at home. Pharmacoepidemiol Drug Saf 2008;17:406–10.
14. Wagner CE, Prentice JA, Saad-Roy CM, Yang L, Grenfell BT, Levin SA, Laxminarayan R. Economic and Behavioral Influencers of Vaccination and Antimicrobial Use. Front Public Health 2020;8.
15. Ngadimon IW, Islahudin F, Hatah E, Shah NM, Makmor-Bakry M. Antibiotic and shared decision-making preferences among adolescents in Malaysia. Patient Prefer Adherence 2015;9:665–73.
16. Cabral C, Zhang T, Oliver I, Little P, Yardley L, Lambert H. Influences on use of antibiotics without prescription by the public in low-and middle-income countries: A systematic review and synthesis of qualitative evidence. JAC Antimicrob Resist 2024;6.
17. Al-Jbouri E, Volk AA, Spadafora N, Andrews NCZ. Friends, followers, peers, and posts: adolescents’ in-person and online friendship networks and social media use influences on friendship closeness via the importance of technology for social connection. Frontiers in Developmental Psychology 2024;2.
18. WHO. Global Accelerated Action for the Health of Adolescents (AA-HA!) Guidance to Support Country Implementation Second Edition. 2023.
19. Guest Greg. “Sampling and selecting participants in field research.” Handbook of methods in cultural anthropology 2. 2014.
20. Kuper A, Reeves S, Levinson W. Qualitative Research: An Introduction to Reading and Appraising Qualitative Research. BMJ: British Medical Journal 2008;337:404–7.
21. Cambaco O, Alonso Menendez Y, Kinsman J, Sigaúque B, Wertheim H, Do N, Gyapong M, John-Langba J, Sevene E, Munguambe K. Community knowledge and practices regarding antibiotic use in rural Mozambique: where is the starting point for prevention of antibiotic resistance? BMC Public Health 2020;20.
22. Shembo AKP, Musumari PM, Srithanaviboonchai K, Tangmunkongvorakul A, Dalleur O. A qualitative study on community use of antibiotics in Kinshasa, Democratic Republic of Congo. PLoS One 2022;17.
23. Torres NF, Solomon VP, Middleton LE. Patterns of self-medication with antibiotics in Maputo City: A qualitative study. Antimicrob Resist Infect Control 2019;8.
24. Cobo-Angel C, LeBlanc SJ, Roche SM, Ritter C. A Focus Group Study of Canadian Dairy Farmers’ Attitudes and Social Referents on Antimicrobial Use and Antimicrobial Resistance. Front Vet Sci 2021;8.
25. Saliba-Gustafsson EA, Nyberg A, Borg MA, Rosales-Klintz S, Lundborg CS. Barriers and facilitators to prudent antibiotic prescribing for acute respiratory tract infections: A qualitative study with general practitioners in Malta. PLoS One 2021;16.
26. Kagoya EK, Royen K Van, Waako P, Royen P Van, Iramiot JS, Obakiro SB, Kostyanev T, Anthierens S. Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study. J Glob Antimicrob Resist 2021;25:66–71.
27. Atif M, Ihsan B, Malik I, Ahmad N, Saleem Z, Sehar A, Babar Z ud D. Antibiotic stewardship program in Pakistan: a multicenter qualitative study exploring medical doctors’ knowledge, perception and practices. BMC Infect Dis 2021;21.
28. Rose J, Crosbie M, Stewart A. A qualitative literature review exploring the drivers influencing antibiotic over-prescribing by GPs in primary care and recommendations to reduce unnecessary prescribing. Perspect Public Health 2021;141:19–27.
29. Duane S, Domegan C, Callan A, Galvin S, Cormican M, Bennett K, Murphy AW, Vellinga A. Using qualitative insights to change practice: exploring the culture of antibiotic prescribing and consumption for urinary tract infections. BMJ Open 2016;6:8894.
30. Jones LF, Owens R, Sallis A, Ashiru-Oredope Di, Thornley T, Francis NA, Butler C, McNulty CAM. Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework. BMJ Open 2018;8.
31. Kamel AM, Omar A, Awad A. The Effectiveness of Ice-breaker Strategy in Enhancing Motivation and Producing Conducive Classroom Atmosphere for the Tenth Graders in English Classes in Nablus City Schools from the Perspectives of Teachers and Students. 2019.
32. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health 2018;6.
33. LYNN MR. Determination and Quantification Of Content Validity. Nurs Res 1986;35.
34. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth 2017;11:S80–9.
35. Chen HY, Boore JRP. Translation and back-translation in qualitative nursing research: Methodological review. J Clin Nurs 2010;19:234–9. 36. of Education M. Education System in Jordan 2024.
37. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101.
38. Maguire M. Doing a thematic analysis: A practical, step-by-step guide for learning and teaching scholars 2017.
39. Clarke V, Braun V. Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. Psychologist 2013;26.
40. Dopelt K, Amar A, Yonatan N, Davidovitch N. Knowledge, attitudes, and practices regarding antibiotic use and resistance: a cross-sectional study among students in Israel. Antibiotics 2023;12:1028.
41. Arpitha GR, Verma A, MR S, Gorbatyuk S, Khan A, Sobahi TR, Asiri AM, Siengchin S. Bio-composite film from corn starch based vetiver cellulose. Journal of Natural Fibers 2022;19:14634–44.
42. Lawani-Luwaji E, Asamaowei M. Assessment of Antibiotic Resistance Knowledge among Female Students in a Hostel Environment: A Concurrent Urine Culture Analysis. Glob Acad J Med Sci 2024;6.
43. Fuhrmeister ER, Larson JR, Kleinschmit AJ, Kirby JE, Pickering AJ, Bascom-Slack CA. Combating antimicrobial resistance through student-driven research and environmental surveillance. Front Microbiol 2021;12:577821.
44. Tiong TW, Chua SS. Knowledge and attitude of university students on antibiotics: A cross-sectional study in Malaysia. Drug Healthc Patient Saf 2020:135–44.
45. Hameed H, Faheem S, Paiva-Santos AC, Sarwar HS, Jamshaid M. A comprehensive review of hydrogel-based drug delivery systems: classification, properties, recent trends, and applications. AAPS PharmSciTech 2024;25:64.
46. Gautham M, Spicer N, Chatterjee S, Goodman C. What are the challenges for antibiotic stewardship at the community level? An analysis of the drivers of antibiotic provision by informal healthcare providers in rural India. Soc Sci Med 2021;275:113813.
47. Duan L, Liu C, Wang D. The general population’s inappropriate behaviors and misunderstanding of antibiotic use in China: a systematic review and meta-analysis. Antibiotics 2021;10:497.
48. Blum R, Kreitman K. Factors affecting individual use of medicines. Pharmaceuticals and health policy, Routledge; 2022, p. 122–85.
49. Mabrouk A Ben, Ammari FL, Werdani A, Jemmali N, Chelli J, Mrabet HE, Rassas A, Sfar MH, El Mhamdi S, Mahjoub B. Parental self-medication with antibiotics in a Tunisian pediatric center. Therapies 2022;77:477–85.
50. Qamariat H. Rational and irrational drug use: factors, impacts and strategies to combat irrational drug use: a narrative review. Int J Pharm Sci Clin Pharm 2021;2:6–17.
51. Zewdie S, Kassa AA, Yayehrad AT, Bizuneh MM, Ayenew W, Zewudie M, Mulat S, Bitew BE, Zewudie S, Meharie BG. Non- prescription antibiotic use and its predictors among children in low-and middle-income countries: a systematic review and meta-analysis. Ital J Pediatr 2024;50:260.
52. Mukattash TL, Jarab AS, Al-Qerem W, Abu Farha RK, Itani R, Karout S, Mukattash IL, Basheti I. Providing pharmaceutical care during the COVID-19 pandemic: attitudes and experiences of home-treated patients in Jordan. Journal of Pharmaceutical Health Services Research 2021;12:321–4.
53. Byrne D. A worked example of Braun and Clarke’s approach to reflexive thematic analysis. Qual Quant 2022;56:1391–412.
54. Saeed U, Insaf RA, Piracha ZZ, Tariq MN, Sohail A, Abbasi UA, Fida Rana MS, Gilani SS, Noor S, Noor E. Crisis averted: a world united against the menace of multiple drug-resistant superbugs-pioneering anti-AMR vaccines, RNA interference, nanomedicine, CRISPR-based antimicrobials, bacteriophage therapies, and clinical artificial intelligence strategies to safeguard global antimicrobial arsenal. Front Microbiol 2023;14:1270018.
55. Uddin TM, Chakraborty AJ, Khusro A, Zidan BMRM, Mitra S, Emran T Bin, Dhama K, Ripon MKH, Gajdács M, Sahibzada MUK. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects. J Infect Public Health 2021;14:1750–66.
56. Sulieman M, Hall MAK, Wong G, Ahmed R. When it’s not pancreatitis, don’t brush it off: a case report of small bowel perforation caused by a grill brush bristle masquerading as pancreatitis. Cureus 2022;14.
57. Mendoza AMB, Maliñana SAA, Maravillas SID, Moniva KC, Jazul JP. Relationship of self-medication and antimicrobial resistance (AMR) in low-and middle-income countries (LMICs): a scoping review. J Public Health Emerg 2025;9.
58. Islam MW, Shahjahan M, Azad AK, Hossain MJ. Factors contributing to antibiotic misuse among parents of school-going children in Dhaka City, Bangladesh. Sci Rep 2024;14.
59. Almeshal N, Foot H, Clarke AL, Chan AHY, Horne R. Understanding patient demand for and use of antibiotics for upper respiratory tract infection: A qualitative application of the Necessity-Concerns Framework in Saudi Arabia. Front Pharmacol 2024;15:1399698.
60. Baxerres C, Sams K, Houngnihin RA, Arhinful DK, Le J-Y. Self-medication versus consultation: Individual autonomy and dependence in health decisions. Understanding Drugs Markets, Routledge; 2021, p. 225–48.
61. Anaba EL, Cole-Adeife MO, Oaku RI. Prevalence, pattern, source of drug information, and reasons for self-medication among dermatology patients. Dermatol Ther 2021;34:e14756.
62. Fekadu G, Dugassa D, Negera GZ, Woyessa TB, Turi E, Tolossa T, Fetensa G, Assefa L, Getachew M, Shibiru T. Self-medication practices and associated factors among health-care professionals in selected hospitals of Western Ethiopia. Patient Prefer Adherence 2020:353–61.
63. May U, Bauer C, Schneider-Ziebe A, Giulini-Limbach C. Self-Medication in Europe: Economic and Social Impact on Individuals and Society. Gesundheitsökonomie & Qualitätsmanagement 2023;28:298–310.
64. Ge P, Li Q, Dong M, Niu Y, Han X, Xiong P, Bao Y, Min H, Liu D, Wang S. Self-medication in Chinese residents and the related factors of whether or not they would take suggestions from medical staff as an important consideration during self-medication. Front Public Health 2022;10:1074559.
65. Aslam A, Gajdács M, Zin CS, Ab Rahman NS, Ahmed SI, Zafar MZ, Jamshed S. Evidence of the practice of self-medication with antibiotics among the lay public in low-and middle-income countries: a scoping review. Antibiotics 2020;9:597.
66. Bhati D, Deogade MS, Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus 2023.
67. Papadimou D, Malmqvist E, Ancillotti M. Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values. BMC Public Health 2022;22.
68. Thong KS, Chang CT, Lee M, Lee JCY, Tan HS, Shafie AA. Impact of targeted educational intervention towards public knowledge and perception of antibiotic use and resistance in the state of Perak, Malaysia. Antimicrob Resist Infect Control 2021;10:1–9.
69. Almutairi KS, Okmi EA, Alnofaiei SS, Alshamari WK, Almutairi SH, Alsuwailem SI, Alkhaldi EH, ALSHAMARI WK. The effects of health education on the awareness of antimicrobial resistance among high school students in Riyadh, Saudi Arabia During 2023: a Quasi-experimental Study. Cureus 2023;15.
70. Oliveira RD, Araújo C, Almeida-Aguiar C. In Vitro Antimicrobial Potential of Portuguese Propolis Extracts from Gerês against Pathogenic Microorganisms. Antibiotics 2024;13:655.
71. Gilham EL, Pearce-Smith N, Carter V, Ashiru-Oredope D. Assessment of global antimicrobial resistance campaigns conducted to improve public awareness and antimicrobial use behaviours: a rapid systematic review. BMC Public Health 2024;24:396.
72. Qenab B, Aqel T, Younis H, AbuShweimeh R, Al Zghoul A, Sweedan Z, Omran M, Joshi MP, Konduri N. An educational initiative aimed at increasing antimicrobial resistance awareness among school-going Jordanian youth. Front Public Health 2024;12:1462976.
73. Pennino F, Maccauro ML, Sorrentino M, Gioia M, Riello S, Messineo G, Di Rosa C, Montuori P, Triassi M, Nardone A. Insights from a cross-sectional study on knowledge, attitudes and behaviors concerning antibiotic use in a large metropolitan area: implications for public health and policy interventions. Antibiotics 2023;12:1476.
74. Akande-Sholabi W, Ajamu AT, Adisa R. Prevalence, knowledge and perception of self-medication practice among undergraduate healthcare students. J Pharm Policy Pract 2021;14:49.
75. Ortega-Paredes D, Larrea-Álvarez CM, Torres-Elizalde L, de Janon S, Vinueza-Burgos C, Hidalgo-Arellano L, Šefcová MA, Molina- Cuasapaz G, Fernandez-Moreira E, Larrea-Álvarez M. Antibiotic resistance awareness among undergraduate students in Quito, Ecuador. Antibiotics 2022;11:197.
76. Fuller W, Kapona O, Aboderin AO, Adeyemo AT, Olatunbosun OI, Gahimbare L, Ahmed YA. Education and awareness on antimicrobial resistance in the WHO African region: a systematic review. Antibiotics 2023;12:1613.
77. Ashiru-Oredope D, Casale E, Harvey E, Umoh E, Vasandani S, Reilly J, Hopkins S. Knowledge and attitudes about antibiotics and antibiotic resistance of 2404 UK healthcare workers. Antibiotics 2022;11:1133.
78. Sobierajski T, Mazińska B, Wanke-Rytt M, Hryniewicz W. Knowledge-based attitudes of medical students in antibiotic therapy and antibiotic resistance. A cross-sectional study. Int J Environ Res Public Health 2021;18:3930.
79. Ikwara EA, Siu G, Esther A, Nyadoi R, Humphrey A. Exploring self-care choices: a qualitative study of self-medication insights among university students in Lira City, Northern Uganda. BMJ Public Health 2024;2.
80. Kalam MA, Shano S, Afrose S, Uddin MN, Rahman N, Jalal FA, Akter S, Islam A, Anam MM, Hassan MM. Antibiotics in the community during the COVID-19 pandemic: A qualitative study to understand users’ perspectives of antibiotic seeking and consumption behaviors in Bangladesh. Patient Prefer Adherence 2022:217–33.
81. Kilari VB, Oroszi T. The Misuse of Antibiotics and the Rise of Bacterial Resistance: A Global Concern. Pharmacol Pharm 2024;15:508–23.
82. Gautham M, Bhattacharyya S, Maity S, Roy MB, Balasubramaniam P, Ebata A, Bloom G. “Just as curry is needed to eat rice, antibiotics are needed to cure fever”—a qualitative study of individual, community and health system-level influences on community antibiotic practices in rural West Bengal, India. BMJ Open 2024;14:e076616.
83. Sulis G, Sayood S, Gandra S. How can we tackle the overuse of antibiotics in low-and middle-income countries? Expert Rev Anti Infect Ther 2023;21:1189–201.
84. Ogunnigbo O, Nabiryo M, Atteh M, Muringu E, Olaitan OJ, Rutter V, Ashiru-Oredope D. Exploring the antimicrobial stewardship educational needs of healthcare students and the potential of an antimicrobial prescribing app as an educational tool in selected African countries. Antibiotics 2022;11:691.
85. Bajalan A, Bui T, Salvadori G, Marques D, Schumacher A, Rösing CK, Dahle UR, Petersen FC, Ricomini-Filho AP, Nicolau BF. Awareness regarding antimicrobial resistance and confidence to prescribe antibiotics in dentistry: a cross-continental student survey. Antimicrob Resist Infect Control 2022;11:158.
86. Khan FU, Khan A, Shah S, Hayat K, Usman A, Khan FU, Khan Z, Karataş Y, Ahmad T, Chang J. Exploring undergraduate pharmacy students perspectives towards antibiotics use, antibiotic resistance, and antibiotic stewardship programs along with the pharmacy teachers’ perspectives: a mixed-methods study from Pakistan. Front Pharmacol 2021;12:754000.
87. Cooper L, Sneddon J, Thompson W, Guise T, Robertson D, Smith A. Tackling antimicrobial resistance in practice: dental students’ evaluation of university teaching supplemented by an online course. JAC Antimicrob Resist 2022;4:dlac039.
88. El-Sokkary RH, Badran SG, El Seifi OS, El-Fakharany YM, Tash RME. “Antibiotic prescribing etiquette” an elective course for medical students: could we recruit potential physicians to fight resistance? BMC Med Educ 2023;23:8.
89. Muteeb G, Rehman MT, Shahwan M, Aatif M. Origin of antibiotics and antibiotic resistance, and their impacts on drug development: A narrative review. Pharmaceuticals 2023;16:1615.
90. Hanif MS, Sultan MA, Raza A, Asad MJ, Sultana T, Hussain MI, Wajid U. Antibiotics Overuse and its Consequences: Raising Awareness and Promoting Responsible Use n.d.
91. Majumder MAA, Rahman S, Cohall D, Bharatha A, Singh K, Haque M, Gittens-St Hilaire M. Antimicrobial stewardship: fighting antimicrobial resistance and protecting global public health. Infect Drug Resist 2020:4713–38.
92. Capuozzo M, Zovi A, Langella R, Ottaiano A, Cascella M, Scognamiglio M, Ferrara F. Optimizing antibiotic use: Addressing resistance through effective strategies and health policies. Antibiotics 2024;13:1112.
93. Will CM. The problem and the productivity of ignorance: public health campaigns on antibiotic stewardship. Sociol Rev 2020;68:55–76.
94. Hussein MM, Abdulazeez MS, Hasan NA. THE IMPACT OF ANTIBIOTIC RESISTANCE ON PUBLIC HEALTH: A REVIEW. World 2023;2.
95. Endale H, Mathewos M, Abdeta D. Potential causes of spread of antimicrobial resistance and preventive measures in one health perspective-a review. Infect Drug Resist 2023:7515–45.
96. Al-Yateem N, Lajam AMA, Othman MMG, Ahmed MAA, Ibrahim S, Halimi A, Ahmad FR, Subu MA, Dias JM, Rahman SA. The impact of cultural healthcare practices on Children’s health in the United Arab Emirates: a qualitative study of traditional remedies and implications. Front Public Health 2023;11:1266742.
97. Schneider-Kamp A, Takhar J. Interrogating the pill: Rising distrust and the reshaping of health risk perceptions in the social media age. Soc Sci Med 2023;331:116081.
98. Gernat AA, Santos FBO, Grimes JL. Alternative approaches to antimicrobial use in the Turkey industry: challenges and perspectives. Ger J Vet Res 2021;1:37–47.
99. Pitiriga V, Vrioni G, Saroglou G, Tsakris A. The impact of antibiotic stewardship programs in combating quinolone resistance: a systematic review and recommendations for more efficient interventions. Adv Ther 2017;34:854–65.
100. Scaioli G, Gualano MR, Gili R, Masucci S, Bert F, Siliquini R. Antibiotic use: a cross-sectional survey assessing the knowledge, attitudes and practices amongst students of a school of medicine in Italy. PLoS One 2015;10:e0122476.
101. Michaelidou M, Karageorgos SA, Tsioutis C. Antibiotic use and antibiotic resistance: Public awareness survey in the Republic of Cyprus. Antibiotics 2020;9:759.
102. Ashiru-Oredope D, Hopkins S, Vasandani S, Umoh E, Oloyede O, Nilsson A, Kinsman J, Elsert L, Monnet DL, Group EcdcaPA. Healthcare workers’ knowledge, attitudes and behaviours with respect to antibiotics, antibiotic use and antibiotic resistance across 30 EU/EEA countries in 2019. Eurosurveillance 2021;26:1900633.
103. Pulcini C, Gyssens IC. How to educate prescribers in antimicrobial stewardship practices. Virulence 2013;4:192–202.
104. Wasserman S, Potgieter S, Shoul E, Constant D, Stewart A, Mendelson M, Boyles TH. South African medical students’ perceptions and knowledge about antibiotic resistance and appropriate prescribing: Are we providing adequate training to future prescribers? South African Medical Journal 2017;107:405–10.
105. Malhotra A, Kumar V, Juyal D, Gautam D, Malhotra R. Knowledge, attitude, and practices of health-care providers toward antibiotic prescribing, antibiotic resistance, and multidrug-resistant tuberculosis. Perspect Clin Res 2021;12:146–52.
106. Nguyen TTP, Do TX, Nguyen HA, Nguyen CTT, Meyer JC, Godman B, Skosana P, Nguyen BT. A National Survey of Dispensing Practice and Customer Knowledge on Antibiotic Use in Vietnam and the Implications. Antibiotics 2022;11.
107. Nakwatumbah S, Kibuule D, Godman B, Haakuria V, Kalemeera F, Baker A, Mwangana M, Godman B. Compliance to guidelines for the prescribing of antibiotics in acute infections at Namibia’s national referral hospital: a pilot study and the implications. 2017.
108. Goossens H, Guillemot D, Ferech M, Schlemmer B, Costers M, Van Breda M, Baker LJ, Cars O, Davey PG. National campaigns to improve antibiotic use. Eur J Clin Pharmacol 2006;62:373–9.
109. Tuong W, Larsen ER, Armstrong AW. Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors. J Behav Med 2014;37:218–33.
110. Navarrete E, Hoppe A, Ewerth R. A review on recent advances in video-based learning research: Video features, interaction, tools, and technologies. CEUR Workshop Proceedings; 3052, vol. 3052, Aachen, Germany: RWTH Aachen; 2021, p. 7.
111. Ploetzner R. The effectiveness of enhanced interaction features in educational videos: a meta-analysis. Interactive Learning Environments 2024;32:1597–612.
112. Fonseca MJ, Santos CL, Costa P, Lencastre L, Tavares F. Increasing awareness about antibiotic use and resistance: A hands-on project for high school students 2012.
113. Boban D, Kaur K, Greco S, Pradhan HS, Joshi R, Rakshitha K, Prakash J. The impact of antibiotic resistance training programs on knowledge, attitude, and practice reflection among Indian higher education students. Int J One Health 2023;9:87.
114. Shen F, Han JA. Effectiveness of entertainment education in communicating health information: a systematic review. The State of Asian Communication Research and Directions for the 21st Century 2018:153–64.
115. Pinto ACS, Scopacasa LF, Bezerra LL de AL, Pedrosa JV, Pinheiro PN da C. Use of information and communication technologies in health education for adolescents: integrative review 2017.
116. Eysenbach G. Credibility of health information and digital media: New perspectives and implications for youth. 2007.
117. Marvasi M, Casillas L, Vassallo A, Purchase D. Educational activities for students and citizens supporting the one-health approach on antimicrobial resistance. Antibiotics 2021;10:1519.
118. Hein W, Aglanu LM, Mensah-Sekyere M, Harant A, Brinkel J, Lamshöft M, Lorenz E, Eibach D, Amuasi J. Fighting antimicrobial resistance: development and implementation of the Ghanaian national action plan (2017–2021). Antibiotics 2022;11:613.
119. Monmaturapoj T. Antimicrobial stewardship in hospitals: an exploration of factors that influence or contribute to the implementation of the initiative 2022.
120. Llor C, Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf 2014;5:229–41.
2. Masadeh M, Harun SN, Mukattash T, Alrabadi N. Parental Knowledge and Attitudes Towards Antibiotic Resistance in Children: A Review Article. Curr Pediatr Rev 2025.
3. Al Shikh H, Bani Hani S, Smiran R K. The Impact of Educational Intervention on Jordanian Parents’ Knowledge and Attitudes Regarding Children’s Antibiotic Use. Jordan Journal of Nursing Research 2024;3.
4. Wall S. Prevention of antibiotic resistance–an epidemiological scoping review to identify research categories and knowledge gaps. Glob Health Action 2019;12.
5. Kanan M, Ramadan M, Haif H, Abdullah B, Mubarak J, Ahmad W, Mari S, Hassan S, Eid R, Hasan M, Qahl M, Assiri A, Sultan M, Alrumaih F, Alenzi A. Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward. Antibiotics 2023;12.
6. Abdel-Qader DH, Albassam A, Ismael NS, El-Shara’ AA, Shehri A, Almutairi FS, Al-Harbi DM, Al Zahrani MM, Chen LC, Al Mazrouei N, Mohamed Ibrahim O. Awareness of Antibiotic Use and Resistance in Jordanian Community. J Prim Care Community Health 2020;11.
7. Songco A, Hudson JL, Fox E. A Cognitive Model of Pathological Worry in Children and Adolescents: A Systematic Review. Clin Child Fam Psychol Rev 2020;23:229–49.
8. Steinberg L. Cognitive and affective development in adolescence. Trends Cogn Sci 2005;9:69–74.
9. Masadeh M, Harun SN, Mukattash T, Alrabadi N. Parental Knowledge and Attitudes Towards Antibiotic Resistance in Children: A Review Article. Curr Pediatr Rev 2025.
10. Holstein BE, Andersen A, Krølner R, Due P, Hansen EH. Young adolescents’ use of medicine for headache: Sources of supply, availability and accessibility at home. Pharmacoepidemiol Drug Saf 2008;17:406–10.
11. Masadeh MM, Harun SN, Alrabadi N. Evaluating the Validity and Reliability of Questionnaires Measuring Knowledge, Attitudes, and Practices Towards Antibiotic Resistance Among Youths: A Systematic Review Protocol. Jordan Journal of Pharmaceutical Sciences 2024;17:362–70.
12. Hawking MKD, Lecky DM, Touboul Lundgren P, Aldigs E, Abdulmajed H, Ioannidou E, Paraskeva-Hadjichambi D, Khouri P, Gal M, Hadjichambis AC, Mappouras D, McNulty CAM. Attitudes and behaviours of adolescents towards antibiotics and self-care for respiratory tract infections: A qualitative study. BMJ Open 2017;7.
13. Holstein BE, Andersen A, Krølner R, Due P, Hansen EH. Young adolescents’ use of medicine for headache: Sources of supply, availability and accessibility at home. Pharmacoepidemiol Drug Saf 2008;17:406–10.
14. Wagner CE, Prentice JA, Saad-Roy CM, Yang L, Grenfell BT, Levin SA, Laxminarayan R. Economic and Behavioral Influencers of Vaccination and Antimicrobial Use. Front Public Health 2020;8.
15. Ngadimon IW, Islahudin F, Hatah E, Shah NM, Makmor-Bakry M. Antibiotic and shared decision-making preferences among adolescents in Malaysia. Patient Prefer Adherence 2015;9:665–73.
16. Cabral C, Zhang T, Oliver I, Little P, Yardley L, Lambert H. Influences on use of antibiotics without prescription by the public in low-and middle-income countries: A systematic review and synthesis of qualitative evidence. JAC Antimicrob Resist 2024;6.
17. Al-Jbouri E, Volk AA, Spadafora N, Andrews NCZ. Friends, followers, peers, and posts: adolescents’ in-person and online friendship networks and social media use influences on friendship closeness via the importance of technology for social connection. Frontiers in Developmental Psychology 2024;2.
18. WHO. Global Accelerated Action for the Health of Adolescents (AA-HA!) Guidance to Support Country Implementation Second Edition. 2023.
19. Guest Greg. “Sampling and selecting participants in field research.” Handbook of methods in cultural anthropology 2. 2014.
20. Kuper A, Reeves S, Levinson W. Qualitative Research: An Introduction to Reading and Appraising Qualitative Research. BMJ: British Medical Journal 2008;337:404–7.
21. Cambaco O, Alonso Menendez Y, Kinsman J, Sigaúque B, Wertheim H, Do N, Gyapong M, John-Langba J, Sevene E, Munguambe K. Community knowledge and practices regarding antibiotic use in rural Mozambique: where is the starting point for prevention of antibiotic resistance? BMC Public Health 2020;20.
22. Shembo AKP, Musumari PM, Srithanaviboonchai K, Tangmunkongvorakul A, Dalleur O. A qualitative study on community use of antibiotics in Kinshasa, Democratic Republic of Congo. PLoS One 2022;17.
23. Torres NF, Solomon VP, Middleton LE. Patterns of self-medication with antibiotics in Maputo City: A qualitative study. Antimicrob Resist Infect Control 2019;8.
24. Cobo-Angel C, LeBlanc SJ, Roche SM, Ritter C. A Focus Group Study of Canadian Dairy Farmers’ Attitudes and Social Referents on Antimicrobial Use and Antimicrobial Resistance. Front Vet Sci 2021;8.
25. Saliba-Gustafsson EA, Nyberg A, Borg MA, Rosales-Klintz S, Lundborg CS. Barriers and facilitators to prudent antibiotic prescribing for acute respiratory tract infections: A qualitative study with general practitioners in Malta. PLoS One 2021;16.
26. Kagoya EK, Royen K Van, Waako P, Royen P Van, Iramiot JS, Obakiro SB, Kostyanev T, Anthierens S. Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study. J Glob Antimicrob Resist 2021;25:66–71.
27. Atif M, Ihsan B, Malik I, Ahmad N, Saleem Z, Sehar A, Babar Z ud D. Antibiotic stewardship program in Pakistan: a multicenter qualitative study exploring medical doctors’ knowledge, perception and practices. BMC Infect Dis 2021;21.
28. Rose J, Crosbie M, Stewart A. A qualitative literature review exploring the drivers influencing antibiotic over-prescribing by GPs in primary care and recommendations to reduce unnecessary prescribing. Perspect Public Health 2021;141:19–27.
29. Duane S, Domegan C, Callan A, Galvin S, Cormican M, Bennett K, Murphy AW, Vellinga A. Using qualitative insights to change practice: exploring the culture of antibiotic prescribing and consumption for urinary tract infections. BMJ Open 2016;6:8894.
30. Jones LF, Owens R, Sallis A, Ashiru-Oredope Di, Thornley T, Francis NA, Butler C, McNulty CAM. Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework. BMJ Open 2018;8.
31. Kamel AM, Omar A, Awad A. The Effectiveness of Ice-breaker Strategy in Enhancing Motivation and Producing Conducive Classroom Atmosphere for the Tenth Graders in English Classes in Nablus City Schools from the Perspectives of Teachers and Students. 2019.
32. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health 2018;6.
33. LYNN MR. Determination and Quantification Of Content Validity. Nurs Res 1986;35.
34. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth 2017;11:S80–9.
35. Chen HY, Boore JRP. Translation and back-translation in qualitative nursing research: Methodological review. J Clin Nurs 2010;19:234–9. 36. of Education M. Education System in Jordan 2024.
37. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101.
38. Maguire M. Doing a thematic analysis: A practical, step-by-step guide for learning and teaching scholars 2017.
39. Clarke V, Braun V. Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. Psychologist 2013;26.
40. Dopelt K, Amar A, Yonatan N, Davidovitch N. Knowledge, attitudes, and practices regarding antibiotic use and resistance: a cross-sectional study among students in Israel. Antibiotics 2023;12:1028.
41. Arpitha GR, Verma A, MR S, Gorbatyuk S, Khan A, Sobahi TR, Asiri AM, Siengchin S. Bio-composite film from corn starch based vetiver cellulose. Journal of Natural Fibers 2022;19:14634–44.
42. Lawani-Luwaji E, Asamaowei M. Assessment of Antibiotic Resistance Knowledge among Female Students in a Hostel Environment: A Concurrent Urine Culture Analysis. Glob Acad J Med Sci 2024;6.
43. Fuhrmeister ER, Larson JR, Kleinschmit AJ, Kirby JE, Pickering AJ, Bascom-Slack CA. Combating antimicrobial resistance through student-driven research and environmental surveillance. Front Microbiol 2021;12:577821.
44. Tiong TW, Chua SS. Knowledge and attitude of university students on antibiotics: A cross-sectional study in Malaysia. Drug Healthc Patient Saf 2020:135–44.
45. Hameed H, Faheem S, Paiva-Santos AC, Sarwar HS, Jamshaid M. A comprehensive review of hydrogel-based drug delivery systems: classification, properties, recent trends, and applications. AAPS PharmSciTech 2024;25:64.
46. Gautham M, Spicer N, Chatterjee S, Goodman C. What are the challenges for antibiotic stewardship at the community level? An analysis of the drivers of antibiotic provision by informal healthcare providers in rural India. Soc Sci Med 2021;275:113813.
47. Duan L, Liu C, Wang D. The general population’s inappropriate behaviors and misunderstanding of antibiotic use in China: a systematic review and meta-analysis. Antibiotics 2021;10:497.
48. Blum R, Kreitman K. Factors affecting individual use of medicines. Pharmaceuticals and health policy, Routledge; 2022, p. 122–85.
49. Mabrouk A Ben, Ammari FL, Werdani A, Jemmali N, Chelli J, Mrabet HE, Rassas A, Sfar MH, El Mhamdi S, Mahjoub B. Parental self-medication with antibiotics in a Tunisian pediatric center. Therapies 2022;77:477–85.
50. Qamariat H. Rational and irrational drug use: factors, impacts and strategies to combat irrational drug use: a narrative review. Int J Pharm Sci Clin Pharm 2021;2:6–17.
51. Zewdie S, Kassa AA, Yayehrad AT, Bizuneh MM, Ayenew W, Zewudie M, Mulat S, Bitew BE, Zewudie S, Meharie BG. Non- prescription antibiotic use and its predictors among children in low-and middle-income countries: a systematic review and meta-analysis. Ital J Pediatr 2024;50:260.
52. Mukattash TL, Jarab AS, Al-Qerem W, Abu Farha RK, Itani R, Karout S, Mukattash IL, Basheti I. Providing pharmaceutical care during the COVID-19 pandemic: attitudes and experiences of home-treated patients in Jordan. Journal of Pharmaceutical Health Services Research 2021;12:321–4.
53. Byrne D. A worked example of Braun and Clarke’s approach to reflexive thematic analysis. Qual Quant 2022;56:1391–412.
54. Saeed U, Insaf RA, Piracha ZZ, Tariq MN, Sohail A, Abbasi UA, Fida Rana MS, Gilani SS, Noor S, Noor E. Crisis averted: a world united against the menace of multiple drug-resistant superbugs-pioneering anti-AMR vaccines, RNA interference, nanomedicine, CRISPR-based antimicrobials, bacteriophage therapies, and clinical artificial intelligence strategies to safeguard global antimicrobial arsenal. Front Microbiol 2023;14:1270018.
55. Uddin TM, Chakraborty AJ, Khusro A, Zidan BMRM, Mitra S, Emran T Bin, Dhama K, Ripon MKH, Gajdács M, Sahibzada MUK. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects. J Infect Public Health 2021;14:1750–66.
56. Sulieman M, Hall MAK, Wong G, Ahmed R. When it’s not pancreatitis, don’t brush it off: a case report of small bowel perforation caused by a grill brush bristle masquerading as pancreatitis. Cureus 2022;14.
57. Mendoza AMB, Maliñana SAA, Maravillas SID, Moniva KC, Jazul JP. Relationship of self-medication and antimicrobial resistance (AMR) in low-and middle-income countries (LMICs): a scoping review. J Public Health Emerg 2025;9.
58. Islam MW, Shahjahan M, Azad AK, Hossain MJ. Factors contributing to antibiotic misuse among parents of school-going children in Dhaka City, Bangladesh. Sci Rep 2024;14.
59. Almeshal N, Foot H, Clarke AL, Chan AHY, Horne R. Understanding patient demand for and use of antibiotics for upper respiratory tract infection: A qualitative application of the Necessity-Concerns Framework in Saudi Arabia. Front Pharmacol 2024;15:1399698.
60. Baxerres C, Sams K, Houngnihin RA, Arhinful DK, Le J-Y. Self-medication versus consultation: Individual autonomy and dependence in health decisions. Understanding Drugs Markets, Routledge; 2021, p. 225–48.
61. Anaba EL, Cole-Adeife MO, Oaku RI. Prevalence, pattern, source of drug information, and reasons for self-medication among dermatology patients. Dermatol Ther 2021;34:e14756.
62. Fekadu G, Dugassa D, Negera GZ, Woyessa TB, Turi E, Tolossa T, Fetensa G, Assefa L, Getachew M, Shibiru T. Self-medication practices and associated factors among health-care professionals in selected hospitals of Western Ethiopia. Patient Prefer Adherence 2020:353–61.
63. May U, Bauer C, Schneider-Ziebe A, Giulini-Limbach C. Self-Medication in Europe: Economic and Social Impact on Individuals and Society. Gesundheitsökonomie & Qualitätsmanagement 2023;28:298–310.
64. Ge P, Li Q, Dong M, Niu Y, Han X, Xiong P, Bao Y, Min H, Liu D, Wang S. Self-medication in Chinese residents and the related factors of whether or not they would take suggestions from medical staff as an important consideration during self-medication. Front Public Health 2022;10:1074559.
65. Aslam A, Gajdács M, Zin CS, Ab Rahman NS, Ahmed SI, Zafar MZ, Jamshed S. Evidence of the practice of self-medication with antibiotics among the lay public in low-and middle-income countries: a scoping review. Antibiotics 2020;9:597.
66. Bhati D, Deogade MS, Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus 2023.
67. Papadimou D, Malmqvist E, Ancillotti M. Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values. BMC Public Health 2022;22.
68. Thong KS, Chang CT, Lee M, Lee JCY, Tan HS, Shafie AA. Impact of targeted educational intervention towards public knowledge and perception of antibiotic use and resistance in the state of Perak, Malaysia. Antimicrob Resist Infect Control 2021;10:1–9.
69. Almutairi KS, Okmi EA, Alnofaiei SS, Alshamari WK, Almutairi SH, Alsuwailem SI, Alkhaldi EH, ALSHAMARI WK. The effects of health education on the awareness of antimicrobial resistance among high school students in Riyadh, Saudi Arabia During 2023: a Quasi-experimental Study. Cureus 2023;15.
70. Oliveira RD, Araújo C, Almeida-Aguiar C. In Vitro Antimicrobial Potential of Portuguese Propolis Extracts from Gerês against Pathogenic Microorganisms. Antibiotics 2024;13:655.
71. Gilham EL, Pearce-Smith N, Carter V, Ashiru-Oredope D. Assessment of global antimicrobial resistance campaigns conducted to improve public awareness and antimicrobial use behaviours: a rapid systematic review. BMC Public Health 2024;24:396.
72. Qenab B, Aqel T, Younis H, AbuShweimeh R, Al Zghoul A, Sweedan Z, Omran M, Joshi MP, Konduri N. An educational initiative aimed at increasing antimicrobial resistance awareness among school-going Jordanian youth. Front Public Health 2024;12:1462976.
73. Pennino F, Maccauro ML, Sorrentino M, Gioia M, Riello S, Messineo G, Di Rosa C, Montuori P, Triassi M, Nardone A. Insights from a cross-sectional study on knowledge, attitudes and behaviors concerning antibiotic use in a large metropolitan area: implications for public health and policy interventions. Antibiotics 2023;12:1476.
74. Akande-Sholabi W, Ajamu AT, Adisa R. Prevalence, knowledge and perception of self-medication practice among undergraduate healthcare students. J Pharm Policy Pract 2021;14:49.
75. Ortega-Paredes D, Larrea-Álvarez CM, Torres-Elizalde L, de Janon S, Vinueza-Burgos C, Hidalgo-Arellano L, Šefcová MA, Molina- Cuasapaz G, Fernandez-Moreira E, Larrea-Álvarez M. Antibiotic resistance awareness among undergraduate students in Quito, Ecuador. Antibiotics 2022;11:197.
76. Fuller W, Kapona O, Aboderin AO, Adeyemo AT, Olatunbosun OI, Gahimbare L, Ahmed YA. Education and awareness on antimicrobial resistance in the WHO African region: a systematic review. Antibiotics 2023;12:1613.
77. Ashiru-Oredope D, Casale E, Harvey E, Umoh E, Vasandani S, Reilly J, Hopkins S. Knowledge and attitudes about antibiotics and antibiotic resistance of 2404 UK healthcare workers. Antibiotics 2022;11:1133.
78. Sobierajski T, Mazińska B, Wanke-Rytt M, Hryniewicz W. Knowledge-based attitudes of medical students in antibiotic therapy and antibiotic resistance. A cross-sectional study. Int J Environ Res Public Health 2021;18:3930.
79. Ikwara EA, Siu G, Esther A, Nyadoi R, Humphrey A. Exploring self-care choices: a qualitative study of self-medication insights among university students in Lira City, Northern Uganda. BMJ Public Health 2024;2.
80. Kalam MA, Shano S, Afrose S, Uddin MN, Rahman N, Jalal FA, Akter S, Islam A, Anam MM, Hassan MM. Antibiotics in the community during the COVID-19 pandemic: A qualitative study to understand users’ perspectives of antibiotic seeking and consumption behaviors in Bangladesh. Patient Prefer Adherence 2022:217–33.
81. Kilari VB, Oroszi T. The Misuse of Antibiotics and the Rise of Bacterial Resistance: A Global Concern. Pharmacol Pharm 2024;15:508–23.
82. Gautham M, Bhattacharyya S, Maity S, Roy MB, Balasubramaniam P, Ebata A, Bloom G. “Just as curry is needed to eat rice, antibiotics are needed to cure fever”—a qualitative study of individual, community and health system-level influences on community antibiotic practices in rural West Bengal, India. BMJ Open 2024;14:e076616.
83. Sulis G, Sayood S, Gandra S. How can we tackle the overuse of antibiotics in low-and middle-income countries? Expert Rev Anti Infect Ther 2023;21:1189–201.
84. Ogunnigbo O, Nabiryo M, Atteh M, Muringu E, Olaitan OJ, Rutter V, Ashiru-Oredope D. Exploring the antimicrobial stewardship educational needs of healthcare students and the potential of an antimicrobial prescribing app as an educational tool in selected African countries. Antibiotics 2022;11:691.
85. Bajalan A, Bui T, Salvadori G, Marques D, Schumacher A, Rösing CK, Dahle UR, Petersen FC, Ricomini-Filho AP, Nicolau BF. Awareness regarding antimicrobial resistance and confidence to prescribe antibiotics in dentistry: a cross-continental student survey. Antimicrob Resist Infect Control 2022;11:158.
86. Khan FU, Khan A, Shah S, Hayat K, Usman A, Khan FU, Khan Z, Karataş Y, Ahmad T, Chang J. Exploring undergraduate pharmacy students perspectives towards antibiotics use, antibiotic resistance, and antibiotic stewardship programs along with the pharmacy teachers’ perspectives: a mixed-methods study from Pakistan. Front Pharmacol 2021;12:754000.
87. Cooper L, Sneddon J, Thompson W, Guise T, Robertson D, Smith A. Tackling antimicrobial resistance in practice: dental students’ evaluation of university teaching supplemented by an online course. JAC Antimicrob Resist 2022;4:dlac039.
88. El-Sokkary RH, Badran SG, El Seifi OS, El-Fakharany YM, Tash RME. “Antibiotic prescribing etiquette” an elective course for medical students: could we recruit potential physicians to fight resistance? BMC Med Educ 2023;23:8.
89. Muteeb G, Rehman MT, Shahwan M, Aatif M. Origin of antibiotics and antibiotic resistance, and their impacts on drug development: A narrative review. Pharmaceuticals 2023;16:1615.
90. Hanif MS, Sultan MA, Raza A, Asad MJ, Sultana T, Hussain MI, Wajid U. Antibiotics Overuse and its Consequences: Raising Awareness and Promoting Responsible Use n.d.
91. Majumder MAA, Rahman S, Cohall D, Bharatha A, Singh K, Haque M, Gittens-St Hilaire M. Antimicrobial stewardship: fighting antimicrobial resistance and protecting global public health. Infect Drug Resist 2020:4713–38.
92. Capuozzo M, Zovi A, Langella R, Ottaiano A, Cascella M, Scognamiglio M, Ferrara F. Optimizing antibiotic use: Addressing resistance through effective strategies and health policies. Antibiotics 2024;13:1112.
93. Will CM. The problem and the productivity of ignorance: public health campaigns on antibiotic stewardship. Sociol Rev 2020;68:55–76.
94. Hussein MM, Abdulazeez MS, Hasan NA. THE IMPACT OF ANTIBIOTIC RESISTANCE ON PUBLIC HEALTH: A REVIEW. World 2023;2.
95. Endale H, Mathewos M, Abdeta D. Potential causes of spread of antimicrobial resistance and preventive measures in one health perspective-a review. Infect Drug Resist 2023:7515–45.
96. Al-Yateem N, Lajam AMA, Othman MMG, Ahmed MAA, Ibrahim S, Halimi A, Ahmad FR, Subu MA, Dias JM, Rahman SA. The impact of cultural healthcare practices on Children’s health in the United Arab Emirates: a qualitative study of traditional remedies and implications. Front Public Health 2023;11:1266742.
97. Schneider-Kamp A, Takhar J. Interrogating the pill: Rising distrust and the reshaping of health risk perceptions in the social media age. Soc Sci Med 2023;331:116081.
98. Gernat AA, Santos FBO, Grimes JL. Alternative approaches to antimicrobial use in the Turkey industry: challenges and perspectives. Ger J Vet Res 2021;1:37–47.
99. Pitiriga V, Vrioni G, Saroglou G, Tsakris A. The impact of antibiotic stewardship programs in combating quinolone resistance: a systematic review and recommendations for more efficient interventions. Adv Ther 2017;34:854–65.
100. Scaioli G, Gualano MR, Gili R, Masucci S, Bert F, Siliquini R. Antibiotic use: a cross-sectional survey assessing the knowledge, attitudes and practices amongst students of a school of medicine in Italy. PLoS One 2015;10:e0122476.
101. Michaelidou M, Karageorgos SA, Tsioutis C. Antibiotic use and antibiotic resistance: Public awareness survey in the Republic of Cyprus. Antibiotics 2020;9:759.
102. Ashiru-Oredope D, Hopkins S, Vasandani S, Umoh E, Oloyede O, Nilsson A, Kinsman J, Elsert L, Monnet DL, Group EcdcaPA. Healthcare workers’ knowledge, attitudes and behaviours with respect to antibiotics, antibiotic use and antibiotic resistance across 30 EU/EEA countries in 2019. Eurosurveillance 2021;26:1900633.
103. Pulcini C, Gyssens IC. How to educate prescribers in antimicrobial stewardship practices. Virulence 2013;4:192–202.
104. Wasserman S, Potgieter S, Shoul E, Constant D, Stewart A, Mendelson M, Boyles TH. South African medical students’ perceptions and knowledge about antibiotic resistance and appropriate prescribing: Are we providing adequate training to future prescribers? South African Medical Journal 2017;107:405–10.
105. Malhotra A, Kumar V, Juyal D, Gautam D, Malhotra R. Knowledge, attitude, and practices of health-care providers toward antibiotic prescribing, antibiotic resistance, and multidrug-resistant tuberculosis. Perspect Clin Res 2021;12:146–52.
106. Nguyen TTP, Do TX, Nguyen HA, Nguyen CTT, Meyer JC, Godman B, Skosana P, Nguyen BT. A National Survey of Dispensing Practice and Customer Knowledge on Antibiotic Use in Vietnam and the Implications. Antibiotics 2022;11.
107. Nakwatumbah S, Kibuule D, Godman B, Haakuria V, Kalemeera F, Baker A, Mwangana M, Godman B. Compliance to guidelines for the prescribing of antibiotics in acute infections at Namibia’s national referral hospital: a pilot study and the implications. 2017.
108. Goossens H, Guillemot D, Ferech M, Schlemmer B, Costers M, Van Breda M, Baker LJ, Cars O, Davey PG. National campaigns to improve antibiotic use. Eur J Clin Pharmacol 2006;62:373–9.
109. Tuong W, Larsen ER, Armstrong AW. Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors. J Behav Med 2014;37:218–33.
110. Navarrete E, Hoppe A, Ewerth R. A review on recent advances in video-based learning research: Video features, interaction, tools, and technologies. CEUR Workshop Proceedings; 3052, vol. 3052, Aachen, Germany: RWTH Aachen; 2021, p. 7.
111. Ploetzner R. The effectiveness of enhanced interaction features in educational videos: a meta-analysis. Interactive Learning Environments 2024;32:1597–612.
112. Fonseca MJ, Santos CL, Costa P, Lencastre L, Tavares F. Increasing awareness about antibiotic use and resistance: A hands-on project for high school students 2012.
113. Boban D, Kaur K, Greco S, Pradhan HS, Joshi R, Rakshitha K, Prakash J. The impact of antibiotic resistance training programs on knowledge, attitude, and practice reflection among Indian higher education students. Int J One Health 2023;9:87.
114. Shen F, Han JA. Effectiveness of entertainment education in communicating health information: a systematic review. The State of Asian Communication Research and Directions for the 21st Century 2018:153–64.
115. Pinto ACS, Scopacasa LF, Bezerra LL de AL, Pedrosa JV, Pinheiro PN da C. Use of information and communication technologies in health education for adolescents: integrative review 2017.
116. Eysenbach G. Credibility of health information and digital media: New perspectives and implications for youth. 2007.
117. Marvasi M, Casillas L, Vassallo A, Purchase D. Educational activities for students and citizens supporting the one-health approach on antimicrobial resistance. Antibiotics 2021;10:1519.
118. Hein W, Aglanu LM, Mensah-Sekyere M, Harant A, Brinkel J, Lamshöft M, Lorenz E, Eibach D, Amuasi J. Fighting antimicrobial resistance: development and implementation of the Ghanaian national action plan (2017–2021). Antibiotics 2022;11:613.
119. Monmaturapoj T. Antimicrobial stewardship in hospitals: an exploration of factors that influence or contribute to the implementation of the initiative 2022.
120. Llor C, Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf 2014;5:229–41.
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Knowledge, Attitudes, and Practices of adolescents regardingantibiotic use and resistance: A Qualitative study from adeveloping country. Pharm Pract (Granada) [Internet]. 2026 Jun. 20 [cited 2026 Jun. 21];24(2):1-19. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/3443
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How to Cite
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Knowledge, Attitudes, and Practices of adolescents regardingantibiotic use and resistance: A Qualitative study from adeveloping country. Pharm Pract (Granada) [Internet]. 2026 Jun. 20 [cited 2026 Jun. 21];24(2):1-19. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/3443