Knowledge and attitudes toward antimicrobial use, resistance, and stewardship among final-year veterinary students: a multinational cross-sectional survey.
21 affiliations
- 1Department of Biological Sciences, Royal Holloway University of London, Egham, United Kingdom.
- 2Department of Animal Hygiene and Preventive Medicine, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
- 3Department of Veterinary Microbiology, Veterinary College, Karnataka Veterinary Animal and Fisheries Sciences University, Bengaluru, India.
- 4Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin, Nigeria.
- 5Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Ataturk University, Erzurum, Türkiye.
- 6Laboratory of Infectious Animal Diseases, Zoonoses and Sanitary Regulation, National School of Veterinary Medicine of Sidi Thabet, Institution of Agricultural Research and Higher Education, University Manouba, Sidi Thabet, Tunisia.
- 7Division of Global Agriculture and Food System, The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Midlothian, United Kingdom.
- 8Institute of Veterinary Sciences, University Frères Mentouri Constantine 1, Constantine, Algeria.
- 9Department of Geography and Sociology, Royal Holloway University of London, Egham, United Kingdom.
- 10GBADs, Roslin Institute, The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Midlothian, United Kingdom.
- 11Biotechnology Research Innovation Council, National Institute of Animal Biotechnology, Hyderabad, India.
- 12School of Design, LCC, University of the Arts London, London, United Kingdom.
- 13Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.
- 14Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Michael Okpara University of Agriculture, Umudike, Nigeria.
- 15Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Nigeria.
- 16Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Nigeria.
- 17Faculty of Veterinary Medicine, Egyptian Chinese University, Nasr City, Cairo, Egypt.
- 18Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan, Nigeria.
- 19Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan.
- 20Department of Animal Nutrition and Nutritional Diseases, Faculty of Veterinary Medicine, Kafkas University, Kars, Türkiye.
- 21Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom.
Abstract
Introduction
This study assessed final-year veterinary students' knowledge and attitudes regarding antimicrobial use (AMU), antimicrobial stewardship (AMS), and antimicrobial resistance (AMR).Methods
Students were invited to complete an online semi-structured questionnaire. A total of 907 participants from 7 countries and 43 veterinary educational establishments (VEEs) completed the questionnaire. Data were analysed using descriptive and inferential statistics. The total knowledge and attitude scores for each student were calculated, and a general average was obtained.Results
AMR was mostly taught as an addendum under the core subjects of microbiology and pharmacology. Students exhibited low AMS knowledge scores (mean score 32.1 ± 22.7), but higher scores for positive attitudes towards reducing AMR (64.2 ± 25.2). Only 6.6% could name at least one national regulation guiding AMU in their countries, while 30-50% of the students knew that antibiotics were inappropriate for various viral infections. About 42% considered it acceptable to use antimicrobials for growth promotion and prophylaxis. Students exhibited positive attitudes towards using antimicrobial susceptibility testing, and 50.1% considered improved veterinary education very important for reducing AMR. Multivariate analyses determined that students' countries of origin were significantly associated with their knowledge and attitudes; for example, Nigerian students were more likely to have good knowledge than Egyptian students, (aOR: 2.372, 95% CI:1.085 - 5.551), while Indian students were less likely (aOR: 0.144, 95% CI: 0.063 - 0.343).Discussion
Greater curricula emphasis should be placed on national and international AMS guidelines. Concepts related to AMR and AMS may be better retained if taught as a standalone module. Further studies should be conducted across countries where students have greater knowledge to evaluate curricula and potentially highlight replicable models for the inclusion of AMR and AMS.
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BibTeX
@article{eltholth2026knowledge,
title = {{Knowledge and attitudes toward antimicrobial use, resistance, and stewardship among final-year veterinary students: a multinational cross-sectional survey.}},
author = {Mahmoud Eltholth and Jadesola Juliana Ajao and Shrikrishna Isloor and Ismail Ayoade Odetokun and Ali Raza and Médiha Khamassi Khbou and Dominic Moran and Ilhem Zouyed and Jennifer Cole and Jonathan Rushton and Nagendra R Hegde and Alison Prendiville and Ghazal Nabil and Uduak Akpabio and Shuaibu Gidado Adamu and Mary Idowu Olasoju and Eman Ahmed Abo Elfadl and Mehmet Cemal Adiguzel and Selim Adewale Alarape and Muhammad Akbar Shahid and Roshan Riaz and Nicola Williams},
journal = {Frontiers in veterinary science},
year = {2026},
month = oct,
doi = {10.3389/fvets.2026.1957292},
url = {https://europepmc.org/article/MED/42904086},
note = {CC BY},
}
RIS
TY - JOUR
TI - Knowledge and attitudes toward antimicrobial use, resistance, and stewardship among final-year veterinary students: a multinational cross-sectional survey.
AU - Mahmoud Eltholth
AU - Jadesola Juliana Ajao
AU - Shrikrishna Isloor
AU - Ismail Ayoade Odetokun
AU - Ali Raza
AU - Médiha Khamassi Khbou
AU - Dominic Moran
AU - Ilhem Zouyed
AU - Jennifer Cole
AU - Jonathan Rushton
AU - Nagendra R Hegde
AU - Alison Prendiville
AU - Ghazal Nabil
AU - Uduak Akpabio
AU - Shuaibu Gidado Adamu
AU - Mary Idowu Olasoju
AU - Eman Ahmed Abo Elfadl
AU - Mehmet Cemal Adiguzel
AU - Selim Adewale Alarape
AU - Muhammad Akbar Shahid
AU - Roshan Riaz
AU - Nicola Williams
PY - 2026
DA - 2026/10/06
JO - Frontiers in veterinary science
DO - 10.3389/fvets.2026.1957292
UR - https://europepmc.org/article/MED/42904086
AB - Introduction This study assessed final-year veterinary students' knowledge and attitudes regarding antimicrobial use (AMU), antimicrobial stewardship (AMS), and antimicrobial resistance (AMR).Methods Students were invited to complete an online semi-structured questionnaire. A total of 907 participants from 7 countries and 43 veterinary educational establishments (VEEs) completed the questionnaire. Data were analysed using descriptive and inferential statistics. The total knowledge and attitude scores for each student were calculated, and a general average was obtained.Results AMR was mostly taught as an addendum under the core subjects of microbiology and pharmacology. Students exhibited low AMS knowledge scores (mean score 32.1 ± 22.7), but higher scores for positive attitudes towards reducing AMR (64.2 ± 25.2). Only 6.6% could name at least one national regulation guiding AMU in their countries, while 30-50% of the students knew that antibiotics were inappropriate for various viral infections. About 42% considered it acceptable to use antimicrobials for growth promotion and prophylaxis. Students exhibited positive attitudes towards using antimicrobial susceptibility testing, and 50.1% considered improved veterinary education very important for reducing AMR. Multivariate analyses determined that students' countries of origin were significantly associated with their knowledge and attitudes; for example, Nigerian students were more likely to have good knowledge than Egyptian students, (aOR: 2.372, 95% CI:1.085 - 5.551), while Indian students were less likely (aOR: 0.144, 95% CI: 0.063 - 0.343).Discussion Greater curricula emphasis should be placed on national and international AMS guidelines. Concepts related to AMR and AMS may be better retained if taught as a standalone module. Further studies should be conducted across countries where students have greater knowledge to evaluate curricula and potentially highlight replicable models for the inclusion of AMR and AMS.
SN - 2297-1769
ER -