Antimicrobial resistance knowledge and behaviors in Irish university students: gaps and opportunities for educational campaigns

Abstract

Abstract Objective: To evaluate the knowledge, attitudes, and behaviors regarding AMR and antimicrobial use among Irish university students and to inform the development of tailored educational interventions. Design: Cross-sectional online survey. Setting: Two Irish universities, 2022. Participants: University students aged 18–25 years (N = 239). Methods: A questionnaire incorporating validated items adapted from the World Health Organisation (WHO) and European Union (EU) barometer survey instruments was administer online. Data were analyzed using descriptive statistics, ANOVA, and principal component analysis. Results: A total 239 students participated (73% female). Mean scores were high for knowledge 77.9% (SD 17.8) and attitudes 74.0% (SD 8.9) with no significant differences by gender, discipline, or health status. However, 18% reported using antibiotics without prescription, while 39%–44% of students demonstrated misconceptions across several statements relating to the use of antibiotics for non-bacterial conditions. Awareness of public AMR campaigns was low (27% “Resist” and 18% European Antibiotic Awareness Day). Principal component analysis identified four attitudinal dimensions: responsible use and preventive behavior, global and collective awareness, innovation and policy solutions, and perceived helplessness and reliance on experts. Conclusions: Although students demonstrated generally high knowledge and positive attitudes towards AMR, important misconceptions and inappropriate antibiotic behaviors remained. The identified attitudinal dimensions suggest that educational interventions should extend beyond knowledge acquisition to address behavioral and attitudinal factors that support responsible antibiotic use and antimicrobial stewardship.