Antimicrobial Resistance Preparedness among Clinical Medical Students in Abuja, Nigeria: Knowledge, Attitudes and Practice Gaps

Abstract

Background: Antimicrobial resistance (AMR) is a major public health challenge, and medical students require both conceptual knowledge and practical prescribing judgement to support future antimicrobial stewardship. This study assessed the knowledge, attitudes, perceptions, and self-reported antimicrobial-use practices of clinical medical students at the University of Abuja Teaching Hospital, Nigeria. Methods: A cross-sectional, questionnaire-based survey was conducted among fourth, fifth, and sixth year clinical medical students at the College of Health Sciences, University of Abuja Teaching Hospital, Gwagwalada. The questionnaire assessed demographic characteristics, knowledge of antimicrobial use and resistance, attitudes toward AMR, and self-reported antimicrobial-use practices. Data were summarized using descriptive statistics, including frequencies, percentages, and proportions. Inferential analyses (chi-square tests) were conducted to examine associations between year of study and key practice indicators. Results: Of 148 students invited, 108 returned usable questionnaires, giving a response rate of 73.0%. Respondents were aged 19-53 years, with most being male (76.9%). Knowledge of key consequences of inappropriate antimicrobial use was generally high, including recognition of bacterial resistance (89.8%), reduced future effectiveness (90.7%), ineffective treatment (87.0%), additional medical cost (85.2%), and prolonged illness (79.6%). Attitudes showed strong recognition of AMR as a serious issue globally (88.7%) and nationally (80.0%), although awareness of AMR as a problem within the teaching hospital was lower (62.1%). Self-reported practices were mixed: most respondents reported completing a full course (71.7%) and checking expiry dates (80.5%), but fewer reported consistently consulting a doctor before starting antimicrobials (38.9%), and some reported using antimicrobials for cough or sore throat (29.6%). Chi-square analysis revealed significant differences in antimicrobial use practices across year levels (p<0.05), with senior students showing slightly more appropriate practices. Conclusion: The findings suggest that clinical medical students at the University of Abuja have substantial AMR awareness but important gaps in practical antimicrobial-use behaviour. Undergraduate training should place stronger emphasis on rational antimicrobial use, clinical decision-making, prescribing behaviour, and antimicrobial stewardship.