Awareness and Knowledge of Antimicrobial Resistance among Dental Students in Nigeria: A Multi-Centre Cross-Sectional Study
DOI:
https://doi.org/10.61172/mg586753Keywords:
Antimicrobial Resistance (AMR); Antimicrobial Stewardship; Dental Education; Prescribing BehaviorAbstract
Background: Antimicrobial resistance (AMR) is a growing global public health threat, with inappropriate antibiotic prescribing in dentistry contributing to its acceleration. Understanding the knowledge and awareness of dental students is critical to inform educational interventions.
Objective: To assess the awareness, knowledge, and ability to identify antibiotics among dental students in six Nigerian universities and evaluate associated demographic and academic factors.
Methods: A cross-sectional study was conducted among dental students in clinical classes (years four to six) across six Nigerian universities: University of Nigeria, University of Port Harcourt, University of Maiduguri, Bayero University, University of Jos, and Obafemi Awolowo University. Pre-tested questionnaires were distributed electronically to each clinical class to assess demographics, awareness, and knowledge of AMR. Completed forms returned numbered 247. Statistical analyses included chi-square tests, logistic regression, one-way ANOVA, and Tukey HSD post hoc tests, with significance set at p ≤ 0.05.
Results: Overall, 53.5% of students demonstrated poor knowledge of AMR. Knowledge improved with academic year (Year 4 vs. Year 6; OR = 2.449, 95% CI: 1.192–5.033; p = 0.015). No significant association was observed between gender and knowledge (p > 0.05). Significant inter-university differences were observed, with higher knowledge levels at University of Nigeria, Nsukka and Obafemi Awolowo University, Ile-Ife. Misidentification of antibiotics was common, with only 12.1% correctly identifying commonly used antibiotics.
Conclusion: AMR knowledge and awareness among Nigerian dental students are suboptimal and influenced by academic year and institution rather than gender. Curriculum harmonization, structured AMR modules, and enhanced clinical exposure are essential to address these gaps.
Key words: Antimicrobial resistance (AMR); Dental students; Antibiotic knowledge; Awareness.
Article Metrics
Downloads
References
1. Hutchings MI, Truman AW, Wilkinson B. Antibiotics: past, present and future. Curr Opin Microbiol. 2019;51:72–80.
2. Katz L, Baltz RH. Natural product discovery: past, present, and future. J Ind Microbiol Biotechnol. 2016;43(2-3):155–76.
3. Bajalan A, Bui T, Salvadori G, Marques D, Schumacher A, Rösing CK, et al. Awareness regarding antimicrobial resistance and confidence to prescribe antibiotics in dentistry: a cross continental student survey. Antimicrob Resist Infect Control. 2022;11(1):158.
4. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, et al. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2013;13(12):1057–98.
5. Teillant A, Gandra S, Barter D, Morgan DJ, Laxminarayan R. Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: a literature review and modelling study. Lancet Infect Dis. 2015;15(12):1429–37.
6. Thompson W, Williams D, Pulcini C, Sanderson S, Calfon P, Verma M. The essential role of the dental team in reducing antibiotic resistance. FDI World Dental Federation; 2020.
7. Poveda Roda R, Bagán JV, Sanchis Bielsa JM, Carbonell Pastor E. Antibiotic use in dental practice: A review. Med Oral Patol Oral Cir Bucal. 2007;12(3):186–92.
8. Almeida VD, Azevedo J, Leal HF, Queiroz AT, da Silva Filho HP, Reis JN. Bacterial diversity and prevalence of antibiotic resistance genes in the oral microbiome. PLoS One. 2020;15(9):e0239664.
9. Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, et al. Antibiotics in Endodontics: a review. Int Endod J. 2017;50(12):1169–84.
10. Farsi N, Alamoudi N, Balto K, Al Mushayt A. Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth. J Clin Pediatr Dent. 2007;31(2):72–6.
11. Bogen G, Kim JS, Bakland LK. Direct pulp capping with mineral trioxide aggregate: an observational study. J Am Dent Assoc. 2008;139(3):305–15.
12. Li Z, Cao L, Fan M, Xu Q. Direct pulp capping with calcium hydroxide or mineral trioxide aggregate: a meta-analysis. J Endod. 2015;41(9):1412–7.
13. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report. Int Endod J. 2006;39(12):921–30.
14. Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, et al. European Society of Endodontology position statement: the use of antibiotics in endodontics. Int Endod J. 2018;51(1):20–5.
15. Ahmadi H, Ebrahimi A, Ahmadi F. Antibiotic therapy in dentistry. Int J Dent. 2021;2021:6667624.
16. Canet JJ, Garau J. Importance of dose and duration of β-lactam therapy in nasopharyngeal colonization with resistant pneumococci. J Antimicrob Chemother. 2002;50(suppl_3):39–44.
17. Wali A, Siddiqui TM, Shafiq K, Siddiqui S, Siddiqui A, Jabbar AA. Assessment of antibiotic prescription patterns amongst dental practitioners: A cross-sectional study. J Int Oral Health. 2015;7(11):5–10.
18. De Vries TP, Henning RH, Hogerzeil HV, Fresle DA. Guide to good prescribing: a practical manual. Geneva: World Health Organization; 1994.
19. Eze C, Akinyemi RO, Eguogwu VC, Mokuolu OA, et al. Demographics of collaborators investigating Nigerian medical and dental interns: MINTING study collaboration. Ann Ib Postgrad Med. 2023;21(2):36–43.
20. Wierzchoń M, Paulewicz B, Asanowicz D, Timmermans B, Cleeremans A. Different subjective awareness measures demonstrate the influence of visual identification on perceptual awareness ratings. Conscious Cogn. 2014;27:109–23.
21. Saunders M, Lewis P, Thornhill A. Research Methods for Business Students. 7th ed. Harlow: Pearson Education Limited; 2015.
22. Maragakis LL, Perencevich EN, Cosgrove SE. Clinical and economic burden of antimicrobial resistance. Expert Rev Anti Infect Ther. 2008;6(5):751–63.
23. Shaik T, Meher BR. Assessment of the knowledge, attitude and practice of rational use of antibiotics among undergraduate dental students in South India. Int J Basic Clin Pharmacol. 2017;6(2):348–54.
24. Cope AL, Francis NA, Wood F, Chestnutt IG. Antibiotic prescription in UK general dental practices: A cross-sectional study. Community Dent Oral Epidemiol. 2016;44(2):145–53.
25. Akande-Sholabi W, Ajamu AT. Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University. BMC Med Educ. 2021;21(1):488.
26. Azevedo MM, Pinheiro C, Yaphe J, Baltazar F. Portuguese students' knowledge of antibiotics: a cross-sectional study of secondary school and university students. BMC Public Health. 2009;9:359.
27. Ahmad A, Khan MU, Patel I, Maharaj S, Pandey S, Dhingra S. Knowledge, attitude and practice of B.Sc. Pharmacy students about antibiotics in Trinidad and Tobago. J Res Pharmacy Pract. 2015;4(1):37–42.
28. Bu-Khamsin A, Fabella E, Al Abdullah A, et al. Association between awareness on antibiotic resistance and antibiotic misuse among Saudi university students. Open Public Health J. 2021;14:545–54.
29. Mallah N, Badro DA, Figueiras A, Takkouche B. Association of knowledge and beliefs with the misuse of antibiotics in parents: A study in Beirut (Lebanon). PLoS One. 2020;15(7):e0232464.
30. Alzahrani AAH, Alzahrani MSA, Aldannish BH, et al. Inappropriate Dental Antibiotic Prescriptions: Potential Driver of the Antimicrobial Resistance in Albaha Region, Saudi Arabia. Risk Manag Healthc Policy. 2020;13:175–82.
31. Sulis G, Daniels B, Kwan A, et al. Antibiotic overuse in the primary health care setting: A secondary data analysis of standardized patient studies from India, China and Kenya. BMJ Glob Health. 2020;5(9):e002393.
32. Kaplan NM, Khader YS, Alfaqih MA, et al. Implementation of the WHO Approved "Tailoring Antimicrobial Resistance Programs (TAP)" Reduces Patients' Request for Antibiotics. Antibiotics (Basel). 2020;9(8):507.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Nathan Ukuoghene Ikimi, Solomon Olusegun Nwhator, Nkolika Uguru, Seidu Adebayo Bello, Kolawole Olalekan Obagbemiro Obagbemiro, Adaeze Nneka Anosike, Ayamma Udo Umanah, Udohchukwu Promise Okereke

This work is licensed under a Creative Commons Attribution 4.0 International License.
Open Access Statement
- We became fully Open Access since January 2023.
- Our new and archived materials are available free of charge on open basis and under a Creative Commons license as stated below.
Copyright statement
Copyright © 1999 The authors. This work, Nigerian Dental Journal by Nigerian Dental Association is licensed under Creative Commons Attribution 4.0 International License.