Assessment of Knowledge, Perception and Factors Affecting the Practice of Antimicrobial Stewardship Among Medical Students, Nursing Students and Pharmacy Students in South-South Nigeria

Antimicrobial resistance (AMR) is a significant global health threat, primarily caused by improper antibiotic use. Antimicrobial stewardship (AMS) programs are vital for improving antibiotic use, but healthcare students—the future prescribers—show varying levels of preparedness. This study evaluated the knowledge, perception, and factors affecting AMS practices among healthcare students in Southern Nigeria. A descriptive cross-sectional survey involved 239 students from medical, nursing, and pharmacy programs. They answered a structured, self-administered questionnaire. We analyzed the data with descriptive statistics and Chi-square tests, using a significance level set at p < 0.05. The results indicated that most respondents were aged 21 to 25 years (58.2%) and were mainly medical students (84.5%), with over half at the 400 level. Knowledge of important AMR and AMS principles was generally high; 91.6% agreed that self-medication contributes to resistance, and 94.6% disagreed with stopping antibiotics once symptoms improve. However, there were still knowledge gaps about antibiotic-associated diarrhea, dosing implications, and side effects. Most perceptions were positive, as 76.6% agreed that antibiotics should not be given without laboratory testing, and 66.9% recognized the clinical importance of antibiograms. Even so, only 37.7% correctly identified an example of de-escalation. Key perceived barriers to AMS practices included insufficient diagnostic tests (82%), poor infection control practices (89.1%), and lack of staff education (85.4%). Knowledge was significantly linked to department (p = 0.006) and level of study (p = 0.000), but not to age or gender. In general, healthcare students showed a solid understanding of AMR and AMS, but they had limited practical skills in stewardship. To improve effective antimicrobial stewardship among future healthcare professionals, targeted curriculum improvements and better diagnostic and health system support are necessary.