Knowledge and Perception of AMR and AMS Among Undergraduate Health Students at UDUS, Nigeria

Background: Antimicrobial resistance (AMR) is a major global public health threat driven largely by inappropriate antimicrobial use and inadequate stewardship. Antimicrobial stewardship (AMS) promotes optimal antimicrobial prescribing to limit resistance. As future prescribers and healthcare providers, undergraduate health students play a critical role in AMR containment; however, evidence regarding their preparedness in Nigeria remains limited. Objective: To assess the knowledge and perceptions of AMR and AMS among final-year undergraduate students in selected health-related faculties at Usmanu Danfodiyo University, Sokoto (UDUS), Nigeria. Methods: A descriptive cross-sectional study was conducted between September and November 2025 among final-year students in Medicine (MBBS), Pharmacy, Nursing Science, Medical Laboratory Science (MLS), and Veterinary Medicine. Using proportionate stratified random sampling, 235 students were recruited from 431 eligible students. Data were collected using a structured, self-administered questionnaire adapted from validated instruments. AMR and AMS knowledge were each scored out of 7 and categorized as poor (0–3), average (4–5), or good (6–7). Data were analyzed using SPSS version 20 with descriptive statistics and chi-square tests. Statistical significance was set at p < 0.05. Results: Overall, 84.7% of respondents demonstrated good knowledge of AMR, while 78.3% demonstrated good knowledge of AMS. Knowledge differed significantly by course of study for both AMR (χ² = 46.33, p < 0.001) and AMS (χ² = 28.70, p < 0.001), with MBBS and Pharmacy students outperforming Nursing students. Despite high levels of knowledge, important misconceptions persisted, including a misunderstanding of resistance mechanisms and support for non-prescription access to antibiotics (57.9%). A majority reported limited formal AMS training within the curriculum (70.6%), yet over 90% expressed a desire for more education on AMR and AMS. Conclusion: Although final-year health students demonstrated satisfactory baseline knowledge of AMR and AMS, significant conceptual gaps and permissive attitudes toward inappropriate antibiotic use remain. Strengthening structured, interprofessional AMS education within undergraduate curricula is urgently needed to prepare future healthcare professionals for effective antimicrobial stewardship in Nigeria.