EXPLORING AWARENESS OF ANTIBIOTIC STEWARDSHIP AMONG UNDERGRADUATE NURSING STUDENTS

Abstract

Background: Antibiotic resistance is a growing global health threat, and nursing students, as future healthcare providers, play a pivotal role in antibiotic stewardship. Antibiotic stewardship was first introduced in the 1990s in response to the growing challenge of antimicrobial resistance (AMR). Initially hospital-focused, stewardship practices have since expanded into outpatient care, veterinary medicine, and agriculture under the broader One Health approach. Nurses play a vital role by administering antibiotics, monitoring patient responses, educating patients, and collaborating with healthcare teams to prevent unnecessary prescribing. The World Health Organization (WHO) has emphasized the importance of undergraduate training programs in promoting responsible antibiotic use. Despite these initiatives, AMR continues to rise, particularly in low-resource countries such as Pakistan, which is among the world’s highest antibiotic consumers. Globally, AMR accounted for 1.27 million deaths in 2019 and is projected to cause 10 million deaths annually by 2050, underscoring the urgent need for improved stewardship through education. Objective: To assess the general and specific knowledge, awareness, and perceptions regarding antibiotic use, resistance, and stewardship among undergraduate nursing students in larkana. Methods: A descriptive cross-sectional study was conducted among 136 nursing students from all four academic years at affiliated colleges of SMBB Medical University Larkana. Data were collected using a structured questionnaire covering demographics, knowledge, awareness, and perceptions of education. Analysis was descriptive, expressed as frequencies, percentages, and overall knowledge scores (OKS). Results: Most participants (88.2%) were aged 21–25 years, and 59.6% were female. General knowledge was moderate; 76.1% correctly identified amoxicillin as an antibiotic, while 41.5% misclassified aspirin. Misconceptions included use for viral infections (26.2%) and pain or inflammation (40.3%). Awareness of adverse effects was moderate (57.9% secondary infections; 58.6% allergic reactions), while only 41.0% understood adherence principles. The overall knowledge score (OKS) had a mean of 15.5 (SD ±5.9; range 0–28), reflecting wide variability among students. Perceptions of education revealed gaps, with only 26.5% feeling adequately trained to select antibiotics, though 40.4% strongly supported further training in stewardship. Conclusion: Nursing students demonstrated moderate knowledge but substantial misconceptions and gaps in practical application. Strengthening curriculum-integrated training on antibiotics, resistance, and stewardship is essential to better prepare future nurses in combating AMR.