Büşra ÇALIŞIR
The Injector - 2026;5(2):52-64
Objective: To compare antibiotic/antimicrobial resistance (AMR) knowledge, antibiotic-use behavior, AMR perceptions, vaccine knowledge and confidence, and trust in health information sources between students enrolled in health-related and non-health-related associate-degree programs. Methods: This single-center cross-sectional study included 128 students from the Vocational School of Health Services and the Vocational School of Technical Sciences at Bursa Uludağ University, Turkey: 65 enrolled in health-related programs and 63 in non-health-related programs. A structured online questionnaire assessed antibiotic/AMR knowledge, rational antibiotic-use behavior, AMR perceptions, vaccine knowledge, vaccine confidence, vaccine hesitancy, and trust in health information sources. Group comparisons, Spearman correlation analyses, and multivariable linear regression models adjusted for age and sex were performed. Results: The median age was 21 years, and 78.9% of participants were female. Antibiotic use during the previous 12 months was similar between groups (50.8% vs 52.4%; p=0.491), whereas vaccination was more frequently reported by students in health-related programs (41.5% vs 11.1%; p<0.001). Students in health-related programs had higher scores for antibiotic/AMR knowledge (7 [IQR, 6-8] vs 4 [3-5.5]), vaccine knowledge (6 [5-7] vs 4 [2-5]), rational antibiotic-use behavior (45 [42-47] vs 41 [37-44]), AMR perception (34 [31-37] vs 28 [24-32]), and vaccine confidence (14 [13-16] vs 12 [8-14]) (all p<0.001). These associations remained significant after adjustment for age and sex (all p<0.001). Antibiotic/AMR knowledge was positively correlated with AMR perception (rho=0.513) and rational antibiotic-use behavior (rho=0.336), while vaccine knowledge was positively correlated with vaccine confidence (rho=0.430) (all p<0.001). Physicians were the most trusted source of health information (87.5%). Trust in several individual professional and institutional sources was positively correlated with vaccine confidence but not with antibiotic/AMR knowledge. Conclusion: Students in health-related programs had higher knowledge, more appropriate antibiotic-use behaviors, stronger AMR perceptions, and greater vaccine confidence than students in non-health-related programs. Nevertheless, important misconceptions, suboptimal treatment-adherence behaviors, and vaccine-related concerns persisted. Educational strategies may benefit from addressing both knowledge gaps and behavioral and confidence-related barriers.
