Knowledge, attitudes, and practices regarding antibiotic use among adults at an infectious diseases clinic

Aims: To assess the knowledge, attitudes, and practices (KAP) regarding antibiotic use among adults attending an infectious diseases outpatient clinic and to identify the sociodemographic factors associated with knowledge. Methods: This cross-sectional study enrolled 245 adults (aged 18 years or older) by consecutive sampling between 23 May and 5 June 2026. A structured four-section questionnaire assessed sociodemographic characteristics, knowledge (12 true/false items; score 0-12), attitudes (10 five-point Likert items; score 10-50), and self-reported practices over the preceding 12 months. Internal consistency was assessed with the Kuder-Richardson 20 (KR-20) and Cronbach alpha coefficients. Non-parametric tests, Spearman correlation, and multiple linear regression were applied, and factors associated with recognising the population level nature of resistance were examined by binary logistic regression. Significance was set at p<0.05. Results: The mean knowledge score was 8.98±2.18 (74.8% of the maximum) and the mean attitude score was 43.35±5.49. The lowest proportions of correct answers concerned the population-level nature of resistance (33.5%) and the ineffectiveness of antibiotics against viral infections (51.0%). Non-prescription use was reported by 11.0% of respondents, and 29.4% stopped treatment early upon symptom relief. University education was the sole independent predictor of knowledge (B=0.91; p=0.016). Recognition that resistance is not confined to those who take antibiotics was independently associated with younger age (adjusted odds ratio [aOR] for 35-49 versus 18-34 years 0.36; 95% confidence interval [CI] 0.19-0.69) and city-centre residence (aOR 2.27; 95% CI 1.26-4.10), but not with education (aOR 1.10; 95% CI 0.50-2.41). The three domain scores were positively intercorrelated (all p<0.001). Conclusion: In this selected, predominantly university-educated outpatient sample, which is not representative of the general adult population, knowledge was generally adequate and attitudes were favourable, yet specific misconceptions and premature discontinuation persisted. The collective nature of resistance was poorly understood irrespective of educational attainment. Education-focused interventions delivered at the point of care and continued stewardship are warranted and require prospective evaluation.