Knowledge, Attitudes, and Practices of Antibiotic Prescribing Among Arab Dental Students: A Cross-Sectional Study

BACKGROUND: Dentists contribute substantially to the global burden of antibiotic use, accounting for approximately 10% of all prescriptions, of which up to 90% might be unnecessary. This exploratory study aimed to assess dental students' knowledge, attitudes, and antibiotic prescribing practices across ten Arab countries. METHODS: This cross-sectional study used convenience sampling to recruit dental students in clinical years from ten Arab nations: Palestine, Jordan, Syria, Lebanon, Iraq, Egypt, Tunisia, Libya, Kuwait, and Saudi Arabia. From these nations, 2168 dental students completed the survey. Hierarchical multiple regression was used to examine factors associated with inappropriate antibiotic prescribing practices, while linear regression assessed factors associated with attitudes toward appropriate antibiotic prescription. RESULTS: In Step 1 of the hierarchical regression, demographic variables explained 6.1% of the variance in prescribing practices. Adding access to antibiotic guidance in Step 2 significantly increased the explained variance to 24.5%, while inclusion of actual knowledge, perceived knowledge, and environmental awareness in Step 3 further increased the explained variance to 33.2%. In the final step, adding attitude and confidence scales resulted in a small additional contribution, explaining 33.7% of the variance. Being a female student, an intern, and coming from a middle-income country were associated with less inappropriate antibiotic prescribing. Perceived knowledge (β = -0.392) had a stronger association with appropriate prescribing than actual knowledge (β = -0.092). More favourable attitudes toward antibiotic use were significantly associated with reduced inappropriate prescribing (β = -0.149). CONCLUSIONS: Appropriate antibiotic prescribing among dental students was associated with demographic characteristics, access to antibiotic guidance, knowledge, and attitudes toward antibiotic use. Perceived knowledge showed a stronger association with prescribing practices than actual knowledge, while favourable attitudes toward antibiotic stewardship were associated with less inappropriate prescribing. These findings suggest that educational interventions should extend beyond factual knowledge to strengthen self-efficacy and stewardship.