Antimicrobial Resistance Knowledge and Awareness among Undergraduate Dental Students: Identifying Educational Gaps

Abstract

Background: Antimicrobial resistance (AMR) is a major global public health concern, with inappropriate antibiotic use contributing to the development of resistance. Dental professionals play an important role in antimicrobial stewardship through rational antibiotic prescribing. Assessing their knowledge and awareness is essential for identifying educational gaps and areas requiring greater emphasis in undergraduate dental education. Objective: To assess antimicrobial resistance (AMR) awareness and antimicrobial-stewardship knowledge among undergraduate dental students and identify specific educational gaps relevant to antimicrobial prescribing education. Methodology: A descriptive cross-sectional questionnaire-based survey was conducted among third- and final-year dental students. The study-specific questionnaire comprised 11 items addressing antimicrobial concepts, antibiotic indications, prophylactic use, antimicrobial overuse, AMR awareness, perception of AMR as a global threat, and educational preference. Eight factual items were used to calculate a knowledge score ranging from 0 to 8. Correct responses were assigned one point and incorrect or uncertain responses were assigned zero points. Two items assessing AMR awareness and perception and one item assessing educational preference were analyzed separately. Knowledge was categorized using predefined study-specific thresholds as poor (0–3), moderate (4–6), or good (7–8). Descriptive statistics were used. Results: Of the 159 responses, 147 contained complete responses to all eight knowledge items. The mean knowledge score was 4.70 ± 1.51 out of 8, and the median was 5 (IQR 4–6), with a range of 0–8. Poor, moderate, and good knowledge were observed in 31 (21.1%), 108 (73.5%), and 8 (5.4%) participants, respectively. AMR awareness was reported by 128/159 (80.5%) respondents, while 122/159 (76.7%) considered AMR an upcoming global threat. Important item-level gaps were identified: only 33/154 (21.4%) correctly rejected broad-spectrum antibiotic use when microbial etiology was uncertain, and 27/154 (17.5%) correctly rejected routine antibiotic prescribing following mechanical intervention. A total of 137/159 (86.2%) supported formal antimicrobial prescribing guideline training before clinical postings. Conclusion: General AMR awareness was relatively high, but specific antimicrobial-stewardship knowledge was predominantly moderate, with marked gaps in clinically relevant prescribing principles. The findings identify areas that may warrant greater emphasis within undergraduate dental antimicrobial-stewardship education. Because the questionnaire was study-specific and actual prescribing behavior was not assessed, the findings should be interpreted as an exploratory educational needs assessment.