Antibiotic use and misuse for dental conditions among respondents from Saudi Arabia, Jordan, and Egypt: a multinational crosssectional survey of knowledge, attitudes, and practices

Abstract

Background Misuse of antibiotics for dental pain and infection contributes to antimicrobial resistance, yet directly comparable community-level evidence from Middle Eastern settings remains limited. Objective To describe antibiotic use and misuse for dental conditions, assess related knowledge and attitudes, and explore sociodemographic associations among respondents from Saudi Arabia, Jordan, and Egypt. Methods A multinational cross-sectional online survey used a structured 21-item English-Arabic questionnaire covering demographics, dental problems, antibiotic-related behaviours, knowledge, attitudes, and information sources. Of 636 submitted questionnaires, 635 complete responses were analysed; behaviour-related items were completed by 516 respondents who reported a dental problem. Age was categorised as 18–25, 26–35, 36– 45, and >45 years and summarised descriptively, but it was not included in inferential analyses because age-by-outcome cross-tabulations were unavailable. Categorical data were summarised using frequencies and percentages. Demographic associations were explored using Pearson chi-square tests, with Benjamini-Hochberg false-discovery-rate correction across 40 tests. The relationship between knowledge and misuse scores was assessed using Spearman rank correlation. Analyses were unadjusted. Results Among 516 respondents reporting a dental problem, 328 (63.6%) reported antibiotic use. Self-medication without professional advice was reported by 264 (51.2%), stopping after symptom improvement by 310 (60.1%), use of leftover antibiotics by 266 (51.6%), and sharing by 236 (45.7%). Only 32.8% recognised that antibiotics do not directly relieve dental pain and 38.1% recognised that antibiotics are not always necessary for dental infections; 69.0% understood that misuse promotes antimicrobial resistance and 72.1% understood that not completing a prescribed course reduces effectiveness. After false-discovery-rate correction, education and occupation remained associated with overall knowledge and each knowledge item. Nationality remained associated with the overall knowledge score and all misuse measures. Education remained associated with all misuse measures, while occupation was associated with early discontinuation, leftover use, sharing, and the overall misuse score. Knowledge correlated weakly and inversely with misuse (Spearman ρ=-0.173, p<0.001). Conclusion Antibiotic use and potentially harmful antibiotic-related behaviours were frequent in this convenience sample. Misconceptions about the role of antibiotics in dental pain were prominent. Public education should be combined with dental stewardship, pharmacy engagement, prescription-only dispensing, and improved access to definitive dental care.

Bangladesh Journal of Medical Science Vol. 25 No. 04 October’26 Page: 1259-1268