Knowledge, attitude, and perception of antibiotic resistance among the United Arab Emirates residents after COVID-19 pandemic: A nationwide cross-sectional study
Main Article Content
Keywords
Antibiotics, Antibiotic resistance, Awareness, Attitudes, Public knowledge
Abstract
Objectives: to provide insights into public knowledge and practices toward antibiotic resistance as well as common behaviours related to antibiotic use and resistance in the UAE. Methods: This study is a cross-sectional, observational investigation into the knowledge, and attitudes, of UAE residents toward antibiotic resistance, using a convenience sampling approach. From May to June 2022, the survey was distributed throughout the seven emirates of the UAE. The methodology was adapted from the WHO's "Antibiotic Resistance: Multi-Country Public Awareness Survey". The study followed the Strengthening Reporting of Obser-vational Studies in Epidemiology reporting (STROBE) guideline for cross-sectional studies. Results: A total of 1074 individuals completed the survey. Approximately two thirds of the respondents (66.0%) were familiar with the term “Antibiotic resistance”. The percentage of respondents who believed that antibiotics could be effective against viral infections decreased from 57.8% to 45.4% after the COVID-19 pandemic period. Additionally, 79.1% of respondents incorrectly believed that antibiotic resistance occurs when their bodies become resistant to antibiotics. Studying in the medical field and having a postgraduate degree were significant predictors of adequate knowledge (Odds ratios were 2.15 and 1.77, respectively). Conclusion: The participants in this study were generally aware of antibiotic resistance; however, incorrect descriptions of antibiotic resistance were frequently encountered. Respondents involved in the medical sector during their studies and those with higher educational degree were more likely to possess adequate knowledge about antibiotic resistance. This evidence can be used to contextualize and enhance the efficiency, effectiveness and success of antimicrobial resistance interventions.
References
1. McNulty, C.A.; Nichols, T.; Boyle, P.J.; Woodhead, M.; Davey, P. The English antibiotic awareness campaigns: did they change
the public’s knowledge of and attitudes to antibiotic use? The Journal of antimicrobial chemotherapy 2010, 65, 1526-1533,
doi:10.1093/jac/dkq126.
2. Jirjees, F.; Al-Obaidi, H.; Sartaj, M.; Conlon-Bingham, G.; Farren, D.; Scott, M.; lopez-lozano, j.m.; Aldeyab, M.; gould, i. Antibiotic
use and resistance in hospitals: time-series analysis strategy for determining and prioritising interventions. 2020, 13-19.
3. Goossens, H.; Ferech, M.; Vander Stichele, R.; Elseviers, M. Outpatient antibiotic use in Europe and association with resistance:
a cross-national database study. Lancet (London, England) 2005, 365, 579-587, doi:10.1016/s0140-6736(05)17907-0.
4. Skalet, A.H.; Cevallos, V.; Ayele, B.; Gebre, T.; Zhou, Z.; Jorgensen, J.H.; Zerihun, M.; Habte, D.; Assefa, Y.; Emerson, P.M.; et al.
Antibiotic selection pressure and macrolide resistance in nasopharyngeal Streptococcus pneumoniae: a cluster-randomized
clinical trial. PLoS medicine 2010, 7, e1000377, doi:10.1371/journal.pmed.1000377.
5. WHO. Antibiotic resistance. Available online: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
(accessed on June 21, 2023).
6. Friedman, N.D.; Temkin, E.; Carmeli, Y. The negative impact of antibiotic resistance. Clinical microbiology and infection : the
official publication of the European Society of Clinical Microbiology and Infectious Diseases 2016, 22, 416-422, doi:10.1016/j.
cmi.2015.12.002.
7. WHO. The world health report 2007: A safer future: global public health security in the 21st century. Available online: https://
apps.who.int/iris/handle/10665/43713 (accessed on June 21, 2023).
8. Al-Kaabi, M.R.; Tariq, W.U.; Hassanein, A.A. Rising bacterial resistance to common antibiotics in Al Ain, United Arab Emirates.
Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al mutawassit 2011, 17, 479-484.
9. Al-Dhaheri, A.S.; Al-Niyadi, M.S.; Al-Dhaheri, A.D.; Bastaki, S.M. Resistance patterns of bacterial isolates to antimicrobials from
3 hospitals in the United Arab Emirates. Saudi medical journal 2009, 30, 618-623.
10. Aly, M.; Balkhy, H.H. The prevalence of antimicrobial resistance in clinical isolates from Gulf Corporation Council countries.
Antimicrobial resistance and infection control 2012, 1, 26, doi:10.1186/2047-2994-1-26.
11. Jens Thomsen, A.S., Adnan Alatoom et al. United Arab Emirates Surveillance of Antimicrobial Resistance: Annual Report
2019. Available online: https://mohap.gov.ae/assets/e9d46624/nationalreport-amr-surveillanceuae%202019mohap.pdf.aspx
(accessed on June 24, 2023).
12. Sachdev, C.; Anjankar, A.; Agrawal, J. Self-Medication With Antibiotics: An Element Increasing Resistance. Cureus 2022, 14,
e30844, doi:10.7759/cureus.30844.
13. Rather, I.A.; Kim, B.C.; Bajpai, V.K.; Park, Y.H. Self-medication and antibiotic resistance: Crisis, current challenges, and prevention.
Saudi journal of biological sciences 2017, 24, 808-812, doi:10.1016/j.sjbs.2017.01.004.
14. Abduelkarem, A.R.; Othman, A.M.; Abuelkhair, Z.M.; Ghazal, M.M.; Alzouobi, S.B.; El Zowalaty, M.E. Prevalence Of Self-
Medication With Antibiotics Among Residents In United Arab Emirates. Infection and drug resistance 2019, 12, 3445-3453,
doi:10.2147/idr.S224720.
15. Jirjees, F.; Ahmed, M.; Sayyar, S.; Amini, M.; Al-Obaidi, H.; Aldeyab, M.A. Self-Medication with Antibiotics during COVID-19 in the
Eastern Mediterranean Region Countries: A Review. Antibiotics (Basel, Switzerland) 2022, 11, doi:10.3390/antibiotics11060733.
16. Jirjees, F.; Barakat, M.; Shubbar, Q.; Othman, B.; Alzubaidi, H.; Al-Obaidi, H. Perceptions of COVID-19 symptoms, prevention,
and treatment strategies among people in seven Arab countries: A cross-sectional study. Journal of infection and public health
2022, 15, 1108-1117, doi:10.1016/j.jiph.2022.08.019.
17. Prestinaci, F.; Pezzotti, P.; Pantosti, A. Antimicrobial resistance: a global multifaceted phenomenon. Pathogens and global
health 2015, 109, 309-318, doi:10.1179/2047773215y.0000000030.
18. Muflih, S.M.; Al-Azzam, S.; Karasneh, R.A.; Conway, B.R.; Aldeyab, M.A. Public Health Literacy, Knowledge, and Awareness
Regarding Antibiotic Use and Antimicrobial Resistance during the COVID-19 Pandemic: A Cross-Sectional Study. Antibiotics
(Basel, Switzerland) 2021, 10, doi:10.3390/antibiotics10091107.
19. ALARABIYA. Majority of UAE residents think antibiotic resistance is health concern: Survey. Available online: https://english.
alarabiya.net/News/gulf/2021/10/07/Majority-of-UAE-residents-think-antibiotic-resistance-is-health-concern-Survey
(accessed on July 7, 2023).
20. Michaelidou, M.; Karageorgos, S.A.; Tsioutis, C. Antibiotic Use and Antibiotic Resistance: Public Awareness Survey in the
Republic of Cyprus. Antibiotics (Basel, Switzerland) 2020, 9, doi:10.3390/antibiotics9110759.
21. Prigitano, A.; Romanò, L.; Auxilia, F.; Castaldi, S.; Tortorano, A.M. Antibiotic resistance: Italian awareness survey 2016. Journal
of infection and public health 2018, 11, 30-34, doi:10.1016/j.jiph.2017.02.010.
22. Salm, F.; Ernsting, C.; Kuhlmey, A.; Kanzler, M.; Gastmeier, P.; Gellert, P. Antibiotic use, knowledge and health literacy among
the general population in Berlin, Germany and its surrounding rural areas. PloS one 2018, 13, e0193336, doi:10.1371/journal.
pone.0193336.
23. Ortega-Paredes, D.; Larrea-Álvarez, C.M.; Torres-Elizalde, L.; de Janon, S.; Vinueza-Burgos, C.; Hidalgo-Arellano, L.; Šefcová,
M.A.; Molina-Cuasapaz, G.; Fernandez-Moreira, E.; Larrea-Álvarez, M. Antibiotic Resistance Awareness among Undergraduate
Students in Quito, Ecuador. Antibiotics (Basel, Switzerland) 2022, 11, doi:10.3390/antibiotics11020197.
24. Leal, H.F.; Mamani, C.; Quach, C.; Bédard, E. Survey on antimicrobial resistance knowledge and perceptions in university
students reveals concerning trends on antibiotic use and procurement. Journal of the Association of Medical Microbiology and
Infectious Disease Canada = Journal officiel de l’Association pour la microbiologie medicale et l’infectiologie Canada 2022, 7,
220-232, doi:10.3138/jammi-2022-0008.
25. Muflih, S.M.; Al-Azzam, S.; Karasneh, R.A.; Bleidt, B.A.; Conway, B.R.; Bond, S.E.; Aldeyab, M.A. Public knowledge of antibiotics,
self-medication, and household disposal practices in Jordan. Expert review of anti-infective therapy 2023, 21, 477-487, doi:10
.1080/14787210.2023.2182770.
26. Aya, M.; Abdurrahman, A.; Salma, R.; Salma, I.A.; Shadwa, K.A.; Shaimaa, A.; Shaimaa, A.M.; Taha, A.Z. Is health literacy
associated with antibiotic use, knowledge and awareness of antimicrobial resistance among non-medical university students
in Egypt? A cross-sectional study. BMJ Open 2021, 11, e046453, doi:10.1136/bmjopen-2020-046453.
27. Jairoun, A.; Hassan, N.; Ali, A.; Jairoun, O.; Shahwan, M. Knowledge, attitude and practice of antibiotic use among university
students: a cross sectional study in UAE. BMC public health 2019, 19, 518, doi:10.1186/s12889-019-6878-y.
28. Mohammad, L.M.; Kamran, R.M.; Gillani, S.W. A study assessing public knowledge and behaviour of antibiotic use in Abu Dhabi
and Dubai. Journal of Pharmaceutical Health Services Research 2023, doi:10.1093/jphsr/rmad033.
29. Shehadeh, M.; Suaifan, G.; Darwish, R.M.; Wazaify, M.; Zaru, L.; Alja’fari, S. Knowledge, attitudes and behavior regarding
antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi pharmaceutical journal : SPJ : the
official publication of the Saudi Pharmaceutical Society 2012, 20, 125-133, doi:10.1016/j.jsps.2011.11.005.
30. Tenaiji, A.; Redha, K.; Khatri, F.; Darmaki, S.; Hosani, S.; Neaimi, M.; Khan, A.; Hashmey, R. Knowledge, Attitudes and Behavior
Towards Antibiotic Use Among Parents in Al-Ain City, United Arab Emirates. International Journal of Infectious Diseases - INT J
INFECT DIS 2008, 12, doi:10.1016/j.ijid.2008.05.1271. 31. Alzoubi, K.; Al-Azzam, S.; Alhusban, A.; Mukattash, T.; Al-Zubaidy, S.; Alomari, N.; Khader, Y. An audit on the knowledge, beliefs
and attitudes about the uses and side-effects of antibiotics among outpatients attending 2 teaching hospitals in Jordan.
Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq almutawassit
2013, 19, 478-484.
32. Cross, E.L.; Tolfree, R.; Kipping, R. Systematic review of public-targeted communication interventions to improve antibiotic use.
The Journal of antimicrobial chemotherapy 2017, 72, 975-987, doi:10.1093/jac/dkw520.
33. Huttner, B.; Goossens, H.; Verheij, T.; Harbarth, S. Characteristics and outcomes of public campaigns aimed at improving the
use of antibiotics in outpatients in high-income countries. The Lancet. Infectious diseases 2010, 10, 17-31, doi:10.1016/s1473-
3099(09)70305-6.
34. Llor, C.; Bjerrum, L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.
Therapeutic advances in drug safety 2014, 5, 229-241, doi:10.1177/2042098614554919.
35. Davis, M.E.; Liu, T.L.; Taylor, Y.J.; Davidson, L.; Schmid, M.; Yates, T.; Scotton, J.; Spencer, M.D. Exploring Patient Awareness
and Perceptions of the Appropriate Use of Antibiotics: A Mixed-Methods Study. Antibiotics (Basel, Switzerland) 2017, 6,
doi:10.3390/antibiotics6040023.
36. Brookes-Howell, L.; Elwyn, G.; Hood, K.; Wood, F.; Cooper, L.; Goossens, H.; Ieven, M.; Butler, C.C. ‘The body gets used to
them’: patients’ interpretations of antibiotic resistance and the implications for containment strategies. Journal of general
internal medicine 2012, 27, 766-772, doi:10.1007/s11606-011-1916-1.
37. Haque, M.; Rahman, N.A.A.; McKimm, J.; Kibria, G.M.; Azim Majumder, M.A.; Haque, S.Z.; Islam, M.Z.; Binti Abdullah, S.L.;
Daher, A.M.; Zulkifli, Z.; et al. Self-medication of antibiotics: investigating practice among university students at the Malaysian
National Defence University. Infection and drug resistance 2019, 12, 1333-1351, doi:10.2147/idr.S203364.
38. Effah, C.Y.; Amoah, A.N.; Liu, H.; Agboyibor, C.; Miao, L.; Wang, J.; Wu, Y. A population-base survey on knowledge, attitude and
awareness of the general public on antibiotic use and resistance. Antimicrobial resistance and infection control 2020, 9, 105,
doi:10.1186/s13756-020-00768-9.
39. Baddal, B.; Lajunen, T.J.; Sullman, M.J.M. Knowledge, attitudes and behaviours regarding antibiotics use among Cypriot
university students: a multi-disciplinary survey. BMC medical education 2022, 22, 847, doi:10.1186/s12909-022-03853-2.
40. Zgliczyński, W.S.; Bartosiński, J.; Rostkowska, O.M. Knowledge and Practice of Antibiotic Management and Prudent Prescribing
among Polish Medical Doctors. International journal of environmental research and public health 2022, 19, doi:10.3390/
ijerph19063739.
41. Ashiru-Oredope, D.; Hopkins, S.; Vasandani, S.; Umoh, E.; Oloyede, O.; Nilsson, A.; Kinsman, J.; Elsert, L.; Monnet, D.L. Healthcare
workers’ knowledge, attitudes and behaviours with respect to antibiotics, antibiotic use and antibiotic resistance across 30 EU/
EEA countries in 2019. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease
bulletin 2021, 26, doi:10.2807/1560-7917.Es.2021.26.12.1900633.
42. Alnasser, A.H.A.; Al-Tawfiq, J.A.; Ahmed, H.A.A.; Alqithami, S.M.H.; Alhaddad, Z.M.A.; Rabiah, A.S.M.; Albrahim, M.A.A.; Al
Kalif, M.S.H.; Barry, M.; Temsah, M.H.; et al. Public knowledge, attitude and practice towards antibiotics use and antimicrobial
resistance in Saudi Arabia: A web-based cross-sectional survey. Journal of public health research 2021, 10, doi:10.4081/
jphr.2021.2276.
43. Abu Taha, A.; Abu-Zaydeh, A.H.; Ardah, R.A.; Al-Jabi, S.W.; Sweileh, W.M.; Awang, R.; Zyoud, S.H. Public Knowledge and
Attitudes Regarding the Use of Antibiotics and Resistance: Findings from a Cross-Sectional Study Among Palestinian Adults.
Zoonoses and public health 2016, 63, 449-457, doi:10.1111/zph.12249.
44. Ling Oh, A.; Hassali, M.A.; Al-Haddad, M.S.; Syed Sulaiman, S.A.; Shafie, A.A.; Awaisu, A. Public knowledge and attitudes
towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. Journal of infection
in developing countries 2011, 5, 338-347, doi:10.3855/jidc.1502.
45. Awad, A.I.; Aboud, E.A. Knowledge, attitude and practice towards antibiotic use among the public in Kuwait. PloS one 2015,
10, e0117910, doi:10.1371/journal.pone.0117910.
46. Mouhieddine, T.H.; Olleik, Z.; Itani, M.M.; Kawtharani, S.; Nassar, H.; Hassoun, R.; Houmani, Z.; El Zein, Z.; Fakih, R.; Mortada,
I.K.; et al. Assessing the Lebanese population for their knowledge, attitudes and practices of antibiotic usage. Journal of
infection and public health 2015, 8, 20-31, doi:10.1016/j.jiph.2014.07.010.
47. Jamhour, A.; El-Kheir, A.; Salameh, P.; Hanna, P.A.; Mansour, H. Antibiotic knowledge and self-medication practices in a developing
country: A cross-sectional study. American journal of infection control 2017, 45, 384-388, doi:10.1016/j.ajic.2016.11.026.
48. Pogurschi, E.N.; Petcu, C.D.; Mizeranschi, A.E.; Zugravu, C.A.; Cirnatu, D.; Pet, I.; Ghimpețeanu, O.M. Knowledge, Attitudes and
Practices Regarding Antibiotic Use and Antibiotic Resistance: A Latent Class Analysis of a Romanian Population. International
journal of environmental research and public health 2022, 19, doi:10.3390/ijerph19127263.
49. Belkina, T.; Al Warafi, A.; Hussein Eltom, E.; Tadjieva, N.; Kubena, A.; Vlcek, J. Antibiotic use and knowledge in the community
of Yemen, Saudi Arabia, and Uzbekistan. Journal of infection in developing countries 2014, 8, 424-429, doi:10.3855/jidc.3866.
50. Van Dijk, J.A.G.M. The Deepening Divide: Inequality in the Information Society; 2005; pp. 1-240.
51. Hargittai, E. Second-Level Digital Divide: Differences in People’s Online Skills. First Monday 2002, 7, doi:10.5210/fm.v7i4.942.
52. Lehdonvirta, V.; Oksanen, A.; Räsänen, P.; Blank, G. Social Media, Web, and Panel Surveys: Using Non-Probability Samples in
Social and Policy Research. 2021, 13, 134-155, doi:https://doi.org/10.1002/poi3.238. 53. WHO. Antibiotic resistance: multi-country public awareness survey. Available online: https://apps.who.int/iris/
handle/10665/194460 (accessed on Jan 14, 2022).
54. Wild, D.; Grove, A.; Martin, M.; Eremenco, S.; McElroy, S.; Verjee-Lorenz, A.; Erikson, P. Principles of Good Practice for the
Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force
for Translation and Cultural Adaptation. 2005, 8, 94-104, doi:https://doi.org/10.1111/j.1524-4733.2005.04054.x.
the public’s knowledge of and attitudes to antibiotic use? The Journal of antimicrobial chemotherapy 2010, 65, 1526-1533,
doi:10.1093/jac/dkq126.
2. Jirjees, F.; Al-Obaidi, H.; Sartaj, M.; Conlon-Bingham, G.; Farren, D.; Scott, M.; lopez-lozano, j.m.; Aldeyab, M.; gould, i. Antibiotic
use and resistance in hospitals: time-series analysis strategy for determining and prioritising interventions. 2020, 13-19.
3. Goossens, H.; Ferech, M.; Vander Stichele, R.; Elseviers, M. Outpatient antibiotic use in Europe and association with resistance:
a cross-national database study. Lancet (London, England) 2005, 365, 579-587, doi:10.1016/s0140-6736(05)17907-0.
4. Skalet, A.H.; Cevallos, V.; Ayele, B.; Gebre, T.; Zhou, Z.; Jorgensen, J.H.; Zerihun, M.; Habte, D.; Assefa, Y.; Emerson, P.M.; et al.
Antibiotic selection pressure and macrolide resistance in nasopharyngeal Streptococcus pneumoniae: a cluster-randomized
clinical trial. PLoS medicine 2010, 7, e1000377, doi:10.1371/journal.pmed.1000377.
5. WHO. Antibiotic resistance. Available online: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
(accessed on June 21, 2023).
6. Friedman, N.D.; Temkin, E.; Carmeli, Y. The negative impact of antibiotic resistance. Clinical microbiology and infection : the
official publication of the European Society of Clinical Microbiology and Infectious Diseases 2016, 22, 416-422, doi:10.1016/j.
cmi.2015.12.002.
7. WHO. The world health report 2007: A safer future: global public health security in the 21st century. Available online: https://
apps.who.int/iris/handle/10665/43713 (accessed on June 21, 2023).
8. Al-Kaabi, M.R.; Tariq, W.U.; Hassanein, A.A. Rising bacterial resistance to common antibiotics in Al Ain, United Arab Emirates.
Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al mutawassit 2011, 17, 479-484.
9. Al-Dhaheri, A.S.; Al-Niyadi, M.S.; Al-Dhaheri, A.D.; Bastaki, S.M. Resistance patterns of bacterial isolates to antimicrobials from
3 hospitals in the United Arab Emirates. Saudi medical journal 2009, 30, 618-623.
10. Aly, M.; Balkhy, H.H. The prevalence of antimicrobial resistance in clinical isolates from Gulf Corporation Council countries.
Antimicrobial resistance and infection control 2012, 1, 26, doi:10.1186/2047-2994-1-26.
11. Jens Thomsen, A.S., Adnan Alatoom et al. United Arab Emirates Surveillance of Antimicrobial Resistance: Annual Report
2019. Available online: https://mohap.gov.ae/assets/e9d46624/nationalreport-amr-surveillanceuae%202019mohap.pdf.aspx
(accessed on June 24, 2023).
12. Sachdev, C.; Anjankar, A.; Agrawal, J. Self-Medication With Antibiotics: An Element Increasing Resistance. Cureus 2022, 14,
e30844, doi:10.7759/cureus.30844.
13. Rather, I.A.; Kim, B.C.; Bajpai, V.K.; Park, Y.H. Self-medication and antibiotic resistance: Crisis, current challenges, and prevention.
Saudi journal of biological sciences 2017, 24, 808-812, doi:10.1016/j.sjbs.2017.01.004.
14. Abduelkarem, A.R.; Othman, A.M.; Abuelkhair, Z.M.; Ghazal, M.M.; Alzouobi, S.B.; El Zowalaty, M.E. Prevalence Of Self-
Medication With Antibiotics Among Residents In United Arab Emirates. Infection and drug resistance 2019, 12, 3445-3453,
doi:10.2147/idr.S224720.
15. Jirjees, F.; Ahmed, M.; Sayyar, S.; Amini, M.; Al-Obaidi, H.; Aldeyab, M.A. Self-Medication with Antibiotics during COVID-19 in the
Eastern Mediterranean Region Countries: A Review. Antibiotics (Basel, Switzerland) 2022, 11, doi:10.3390/antibiotics11060733.
16. Jirjees, F.; Barakat, M.; Shubbar, Q.; Othman, B.; Alzubaidi, H.; Al-Obaidi, H. Perceptions of COVID-19 symptoms, prevention,
and treatment strategies among people in seven Arab countries: A cross-sectional study. Journal of infection and public health
2022, 15, 1108-1117, doi:10.1016/j.jiph.2022.08.019.
17. Prestinaci, F.; Pezzotti, P.; Pantosti, A. Antimicrobial resistance: a global multifaceted phenomenon. Pathogens and global
health 2015, 109, 309-318, doi:10.1179/2047773215y.0000000030.
18. Muflih, S.M.; Al-Azzam, S.; Karasneh, R.A.; Conway, B.R.; Aldeyab, M.A. Public Health Literacy, Knowledge, and Awareness
Regarding Antibiotic Use and Antimicrobial Resistance during the COVID-19 Pandemic: A Cross-Sectional Study. Antibiotics
(Basel, Switzerland) 2021, 10, doi:10.3390/antibiotics10091107.
19. ALARABIYA. Majority of UAE residents think antibiotic resistance is health concern: Survey. Available online: https://english.
alarabiya.net/News/gulf/2021/10/07/Majority-of-UAE-residents-think-antibiotic-resistance-is-health-concern-Survey
(accessed on July 7, 2023).
20. Michaelidou, M.; Karageorgos, S.A.; Tsioutis, C. Antibiotic Use and Antibiotic Resistance: Public Awareness Survey in the
Republic of Cyprus. Antibiotics (Basel, Switzerland) 2020, 9, doi:10.3390/antibiotics9110759.
21. Prigitano, A.; Romanò, L.; Auxilia, F.; Castaldi, S.; Tortorano, A.M. Antibiotic resistance: Italian awareness survey 2016. Journal
of infection and public health 2018, 11, 30-34, doi:10.1016/j.jiph.2017.02.010.
22. Salm, F.; Ernsting, C.; Kuhlmey, A.; Kanzler, M.; Gastmeier, P.; Gellert, P. Antibiotic use, knowledge and health literacy among
the general population in Berlin, Germany and its surrounding rural areas. PloS one 2018, 13, e0193336, doi:10.1371/journal.
pone.0193336.
23. Ortega-Paredes, D.; Larrea-Álvarez, C.M.; Torres-Elizalde, L.; de Janon, S.; Vinueza-Burgos, C.; Hidalgo-Arellano, L.; Šefcová,
M.A.; Molina-Cuasapaz, G.; Fernandez-Moreira, E.; Larrea-Álvarez, M. Antibiotic Resistance Awareness among Undergraduate
Students in Quito, Ecuador. Antibiotics (Basel, Switzerland) 2022, 11, doi:10.3390/antibiotics11020197.
24. Leal, H.F.; Mamani, C.; Quach, C.; Bédard, E. Survey on antimicrobial resistance knowledge and perceptions in university
students reveals concerning trends on antibiotic use and procurement. Journal of the Association of Medical Microbiology and
Infectious Disease Canada = Journal officiel de l’Association pour la microbiologie medicale et l’infectiologie Canada 2022, 7,
220-232, doi:10.3138/jammi-2022-0008.
25. Muflih, S.M.; Al-Azzam, S.; Karasneh, R.A.; Bleidt, B.A.; Conway, B.R.; Bond, S.E.; Aldeyab, M.A. Public knowledge of antibiotics,
self-medication, and household disposal practices in Jordan. Expert review of anti-infective therapy 2023, 21, 477-487, doi:10
.1080/14787210.2023.2182770.
26. Aya, M.; Abdurrahman, A.; Salma, R.; Salma, I.A.; Shadwa, K.A.; Shaimaa, A.; Shaimaa, A.M.; Taha, A.Z. Is health literacy
associated with antibiotic use, knowledge and awareness of antimicrobial resistance among non-medical university students
in Egypt? A cross-sectional study. BMJ Open 2021, 11, e046453, doi:10.1136/bmjopen-2020-046453.
27. Jairoun, A.; Hassan, N.; Ali, A.; Jairoun, O.; Shahwan, M. Knowledge, attitude and practice of antibiotic use among university
students: a cross sectional study in UAE. BMC public health 2019, 19, 518, doi:10.1186/s12889-019-6878-y.
28. Mohammad, L.M.; Kamran, R.M.; Gillani, S.W. A study assessing public knowledge and behaviour of antibiotic use in Abu Dhabi
and Dubai. Journal of Pharmaceutical Health Services Research 2023, doi:10.1093/jphsr/rmad033.
29. Shehadeh, M.; Suaifan, G.; Darwish, R.M.; Wazaify, M.; Zaru, L.; Alja’fari, S. Knowledge, attitudes and behavior regarding
antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi pharmaceutical journal : SPJ : the
official publication of the Saudi Pharmaceutical Society 2012, 20, 125-133, doi:10.1016/j.jsps.2011.11.005.
30. Tenaiji, A.; Redha, K.; Khatri, F.; Darmaki, S.; Hosani, S.; Neaimi, M.; Khan, A.; Hashmey, R. Knowledge, Attitudes and Behavior
Towards Antibiotic Use Among Parents in Al-Ain City, United Arab Emirates. International Journal of Infectious Diseases - INT J
INFECT DIS 2008, 12, doi:10.1016/j.ijid.2008.05.1271. 31. Alzoubi, K.; Al-Azzam, S.; Alhusban, A.; Mukattash, T.; Al-Zubaidy, S.; Alomari, N.; Khader, Y. An audit on the knowledge, beliefs
and attitudes about the uses and side-effects of antibiotics among outpatients attending 2 teaching hospitals in Jordan.
Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq almutawassit
2013, 19, 478-484.
32. Cross, E.L.; Tolfree, R.; Kipping, R. Systematic review of public-targeted communication interventions to improve antibiotic use.
The Journal of antimicrobial chemotherapy 2017, 72, 975-987, doi:10.1093/jac/dkw520.
33. Huttner, B.; Goossens, H.; Verheij, T.; Harbarth, S. Characteristics and outcomes of public campaigns aimed at improving the
use of antibiotics in outpatients in high-income countries. The Lancet. Infectious diseases 2010, 10, 17-31, doi:10.1016/s1473-
3099(09)70305-6.
34. Llor, C.; Bjerrum, L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.
Therapeutic advances in drug safety 2014, 5, 229-241, doi:10.1177/2042098614554919.
35. Davis, M.E.; Liu, T.L.; Taylor, Y.J.; Davidson, L.; Schmid, M.; Yates, T.; Scotton, J.; Spencer, M.D. Exploring Patient Awareness
and Perceptions of the Appropriate Use of Antibiotics: A Mixed-Methods Study. Antibiotics (Basel, Switzerland) 2017, 6,
doi:10.3390/antibiotics6040023.
36. Brookes-Howell, L.; Elwyn, G.; Hood, K.; Wood, F.; Cooper, L.; Goossens, H.; Ieven, M.; Butler, C.C. ‘The body gets used to
them’: patients’ interpretations of antibiotic resistance and the implications for containment strategies. Journal of general
internal medicine 2012, 27, 766-772, doi:10.1007/s11606-011-1916-1.
37. Haque, M.; Rahman, N.A.A.; McKimm, J.; Kibria, G.M.; Azim Majumder, M.A.; Haque, S.Z.; Islam, M.Z.; Binti Abdullah, S.L.;
Daher, A.M.; Zulkifli, Z.; et al. Self-medication of antibiotics: investigating practice among university students at the Malaysian
National Defence University. Infection and drug resistance 2019, 12, 1333-1351, doi:10.2147/idr.S203364.
38. Effah, C.Y.; Amoah, A.N.; Liu, H.; Agboyibor, C.; Miao, L.; Wang, J.; Wu, Y. A population-base survey on knowledge, attitude and
awareness of the general public on antibiotic use and resistance. Antimicrobial resistance and infection control 2020, 9, 105,
doi:10.1186/s13756-020-00768-9.
39. Baddal, B.; Lajunen, T.J.; Sullman, M.J.M. Knowledge, attitudes and behaviours regarding antibiotics use among Cypriot
university students: a multi-disciplinary survey. BMC medical education 2022, 22, 847, doi:10.1186/s12909-022-03853-2.
40. Zgliczyński, W.S.; Bartosiński, J.; Rostkowska, O.M. Knowledge and Practice of Antibiotic Management and Prudent Prescribing
among Polish Medical Doctors. International journal of environmental research and public health 2022, 19, doi:10.3390/
ijerph19063739.
41. Ashiru-Oredope, D.; Hopkins, S.; Vasandani, S.; Umoh, E.; Oloyede, O.; Nilsson, A.; Kinsman, J.; Elsert, L.; Monnet, D.L. Healthcare
workers’ knowledge, attitudes and behaviours with respect to antibiotics, antibiotic use and antibiotic resistance across 30 EU/
EEA countries in 2019. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease
bulletin 2021, 26, doi:10.2807/1560-7917.Es.2021.26.12.1900633.
42. Alnasser, A.H.A.; Al-Tawfiq, J.A.; Ahmed, H.A.A.; Alqithami, S.M.H.; Alhaddad, Z.M.A.; Rabiah, A.S.M.; Albrahim, M.A.A.; Al
Kalif, M.S.H.; Barry, M.; Temsah, M.H.; et al. Public knowledge, attitude and practice towards antibiotics use and antimicrobial
resistance in Saudi Arabia: A web-based cross-sectional survey. Journal of public health research 2021, 10, doi:10.4081/
jphr.2021.2276.
43. Abu Taha, A.; Abu-Zaydeh, A.H.; Ardah, R.A.; Al-Jabi, S.W.; Sweileh, W.M.; Awang, R.; Zyoud, S.H. Public Knowledge and
Attitudes Regarding the Use of Antibiotics and Resistance: Findings from a Cross-Sectional Study Among Palestinian Adults.
Zoonoses and public health 2016, 63, 449-457, doi:10.1111/zph.12249.
44. Ling Oh, A.; Hassali, M.A.; Al-Haddad, M.S.; Syed Sulaiman, S.A.; Shafie, A.A.; Awaisu, A. Public knowledge and attitudes
towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. Journal of infection
in developing countries 2011, 5, 338-347, doi:10.3855/jidc.1502.
45. Awad, A.I.; Aboud, E.A. Knowledge, attitude and practice towards antibiotic use among the public in Kuwait. PloS one 2015,
10, e0117910, doi:10.1371/journal.pone.0117910.
46. Mouhieddine, T.H.; Olleik, Z.; Itani, M.M.; Kawtharani, S.; Nassar, H.; Hassoun, R.; Houmani, Z.; El Zein, Z.; Fakih, R.; Mortada,
I.K.; et al. Assessing the Lebanese population for their knowledge, attitudes and practices of antibiotic usage. Journal of
infection and public health 2015, 8, 20-31, doi:10.1016/j.jiph.2014.07.010.
47. Jamhour, A.; El-Kheir, A.; Salameh, P.; Hanna, P.A.; Mansour, H. Antibiotic knowledge and self-medication practices in a developing
country: A cross-sectional study. American journal of infection control 2017, 45, 384-388, doi:10.1016/j.ajic.2016.11.026.
48. Pogurschi, E.N.; Petcu, C.D.; Mizeranschi, A.E.; Zugravu, C.A.; Cirnatu, D.; Pet, I.; Ghimpețeanu, O.M. Knowledge, Attitudes and
Practices Regarding Antibiotic Use and Antibiotic Resistance: A Latent Class Analysis of a Romanian Population. International
journal of environmental research and public health 2022, 19, doi:10.3390/ijerph19127263.
49. Belkina, T.; Al Warafi, A.; Hussein Eltom, E.; Tadjieva, N.; Kubena, A.; Vlcek, J. Antibiotic use and knowledge in the community
of Yemen, Saudi Arabia, and Uzbekistan. Journal of infection in developing countries 2014, 8, 424-429, doi:10.3855/jidc.3866.
50. Van Dijk, J.A.G.M. The Deepening Divide: Inequality in the Information Society; 2005; pp. 1-240.
51. Hargittai, E. Second-Level Digital Divide: Differences in People’s Online Skills. First Monday 2002, 7, doi:10.5210/fm.v7i4.942.
52. Lehdonvirta, V.; Oksanen, A.; Räsänen, P.; Blank, G. Social Media, Web, and Panel Surveys: Using Non-Probability Samples in
Social and Policy Research. 2021, 13, 134-155, doi:https://doi.org/10.1002/poi3.238. 53. WHO. Antibiotic resistance: multi-country public awareness survey. Available online: https://apps.who.int/iris/
handle/10665/194460 (accessed on Jan 14, 2022).
54. Wild, D.; Grove, A.; Martin, M.; Eremenco, S.; McElroy, S.; Verjee-Lorenz, A.; Erikson, P. Principles of Good Practice for the
Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force
for Translation and Cultural Adaptation. 2005, 8, 94-104, doi:https://doi.org/10.1111/j.1524-4733.2005.04054.x.
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Knowledge, attitude, and perception of antibiotic resistance among the United Arab Emirates residents after COVID-19 pandemic: A nationwide cross-sectional study. Pharm Pract (Granada) [Internet]. 2025 Oct. 8 [cited 2025 Oct. 22];23(3):1-12. Available from: https://pharmacypractice.org/index.php/pp/article/view/3289
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How to Cite
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Knowledge, attitude, and perception of antibiotic resistance among the United Arab Emirates residents after COVID-19 pandemic: A nationwide cross-sectional study. Pharm Pract (Granada) [Internet]. 2025 Oct. 8 [cited 2025 Oct. 22];23(3):1-12. Available from: https://pharmacypractice.org/index.php/pp/article/view/3289