Knowledge and practices towards antibiotic usage in upper respiratory tract infections among university students: A cross-sectional study in a Sri Lankan state university

Purpose: Upper respiratory tract infections are a major cause of antibiotic overuse, contributing to antibiotic resistance, a global health crisis. This study aimed to assess knowledge and practices regarding antibiotic use in upper respiratory tract infections among undergraduates of a state university in Sri Lanka.  
Methods: A descriptive cross-sectional study was conducted among 382 undergraduates at the University of Jaffna, Sri Lanka, from July 2019 to November 2020. Data were collected using a pretested self-administered questionnaire via Google Forms and analysed using descriptive statistics. Participants were classified as having poor or good knowledge based on their scores, which were determined according to a predetermined scale. The chi-square test was used to assess factors associated with antibiotic use for upper respiratory tract infections.
Results: A total of 314 students responded to the questionnaire, with a response rate of 82.1%. Most participants were female (64.0%) with a mean age of 23.12 ± 0.97 years. Poor knowledge regarding antibiotic use in upper respiratory tract infections was observed in 56.5%. Faculty of study (p<0.001) was significantly associated with knowledge, as students enrolled in disciplines categorized under health sciences had better knowledge. Majority of the students (81.2%) reported having upper respiratory tract infections in the past three months, and 42.0% self-medicated with antibiotics. While 71.3% completed the prescribed antibiotic course, 40.1% shared antibiotics with friends or family members.
Conclusion: Undergraduate students participating in this study demonstrated insufficient knowledge of antibiotic use for upper respiratory tract infections, with faculty affiliation playing a significant role. While most adhered to prescriptions, gaps in understanding and practices remain.