Abstract

Background: The misuse of antibiotics and the rise of antimicrobial resistance (AMR) pose serious global health threats. Medical students, as future prescribers, play a critical role in combating AMR.

Objective: To assess the knowledge, attitudes, and practices (KAP) related to antibiotic use and resistance among medical students at I.K. Akhunbaev Kyrgyz State Medical Academy.

Methods: A descriptive cross-sectional study was conducted using a validated, structured questionnaire among 180 MBBS students. Descriptive statistics and chi-square tests were used to analyze data.

Results: While 86% of students recognized AMR as a major global threat, only 42% correctly identified all WHO-recommended rational antibiotic use principles. About 34% admitted to self-prescribing antibiotics without consulting a physician.

Conclusion: Despite awareness of antibiotic resistance, many students showed gaps in knowledge and engaged in inappropriate antibiotic practices. Educational interventions are needed to promote rational antibiotic use.

Keywords: Antibiotic resistance, Knowledge-attitude-practice, Medical students, Kyrgyzstan, Antimicrobial stewardship

Introduction

Antimicrobial resistance (AMR) is a pressing global health concern, projected to cause 10 million deaths annually by 2050 if unchecked. Misuse and overuse of antibiotics are key drivers of AMR. Medical students, as future healthcare providers, must be equipped with accurate knowledge and ethical prescribing practices.

Studies across various countries have shown that while awareness of AMR is widespread, detailed knowledge and responsible antibiotic use among students remain limited. This study aims to evaluate the knowledge, attitudes, and practices related to antibiotic use and resistance among MBBS students in Kyrgyzstan.

Methods

Study Design and Setting

A cross-sectional questionnaire-based study was conducted in March 2025 at I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek.

Participants

A total of 180 students from 2nd to 5th year MBBS were selected using simple random sampling. Participation was voluntary and anonymous.

Instrument

A structured, pre-validated questionnaire was divided into three sections:

1. Knowledge (10 questions on antibiotic function and resistance)
   
   

2. Attitudes (Likert-scale on perception of AMR)
   
   

3. Practices (self-reported antibiotic use behavior)
   
   

Statistical Analysis

Data were analyzed using SPSS v26. Frequencies, percentages, and chi-square tests were used to assess associations. Significance was set at p < 0.05.

Results

Among 180 respondents (56% female, mean age: 21.3 ± 1.4 years), the following were observed:

• Knowledge: 86% correctly agreed that AMR is a serious global problem. However, only 42% could identify the full WHO guidelines for rational antibiotic use.
  
  

• Attitudes: 91% believed unnecessary antibiotic use should be avoided; 78% supported inclusion of more AMR education in the curriculum.
  
  

• Practices: 34% had taken antibiotics without a prescription in the past year; 27% stopped antibiotics once symptoms resolved, not completing the full course.
  
  

There was a statistically significant association (p < 0.01) between year of study and knowledge scores—senior students scored higher.

Discussion

While most students showed good awareness of antibiotic resistance, knowledge of stewardship principles and rational usage was lacking. These results are consistent with studies from India, Turkey, and Eastern Europe. The frequent practice of self-prescribing and early discontinuation of antibiotic courses is concerning.

Interventions such as antibiotic stewardship modules, workshops, and clinical training may improve responsible attitudes and practices among future doctors.

Limitations include reliance on self-reported behavior and limited generalizability beyond the single institution.

Conclusion

Although awareness of AMR is high among medical students in Kyrgyzstan, actual knowledge and responsible antibiotic practices remain insufficient. Strengthening AMR education in undergraduate medical curricula is essential to prepare future doctors for responsible prescribing.

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