Knowledge, Attitudes, And Antibiotic Use Practices for Skin Infections Among Undergraduate Students in Delta State, Nigeria: Implications for Antimicrobial Stewardship
Keywords:
Skin infections, Antibiotic stewardship, Antimicrobial resistance, Self-medicationAbstract
Skin infections are of a significant health concern in communal student environments and are increasingly associated with irrational antibiotic use. This study investigated the knowledge, attitudes, and antibiotic use practices regarding skin infections among tertiary institution students in Delta State, Nigeria, to identify drivers of antimicrobial resistance (AMR). A descriptive cross-sectional multi-center study was conducted among 423 undergraduate students across five tertiary institutions during the 2025/2026 academic session. Participants were selected via a multistage sampling technique. Data were collected using a validated electronic structured questionnaire (Cronbach's alpha = 0.82) and analyzed using descriptive statistics and Chi-square tests at p < 0.05.A majority of respondents (78.5%) reported previous skin infections, primarily acne (59.0%) and boils (41.3%). Although 68.1% had used antibiotics for treatment, only 32.4% demonstrated good knowledge. Inappropriate attitudes towards rational antibiotic use were prevalent (51.1%), with 61.0% admitting to treatment cessation upon symptom resolution. Inappropriate practices were observed in 61.9% of the cohort; specifically, 65.5% engaged in self-medication and 65.2% accessed antibiotics from pharmacies without a prescription. Significant statistical associations were established between practice scores and both knowledge (χ² = 38.4, p < 0.001) and attitudes (χ² = 31.2, p < 0.001). Deficiencies in antimicrobial literacy and permissive attitudes toward self- medication substantially influence irrational antibiotic consumption in this population. The findings underscore an urgent need for targeted antimicrobial stewardship programmes and stricter regulatory enforcement of prescription-only medicine sales to mitigate the escalating threat of AMR.
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