Abstract
BACKGROUND: Antibiotic self-medication (ASM) is a significant global health concern contributing to antimicrobial resistance (AMR), particularly in low- and middle-income countries, including Saudi Arabia. Despite regulatory controls, inappropriate antibiotic use persists in primary care settings. AIM: This study aimed to assess the prevalence, sources, and behavioral patterns of ASM and to evaluate knowledge, awareness, and attitudes toward antibiotic use among adults attending primary care clinics in Saudi Arabia. METHODS: A cross-sectional survey was conducted with 421 adult participants selected through random sampling from various primary care centers in Saudi Arabia: Family and Community Medicine Center, Dammam, and Imam Abdulrahman Bin Faisal University PHC, Dammam. A structured, self-administered questionnaire captured demographic data, antibiotic use frequency, sources, knowledge, awareness of AMR, and attitudes. Data were analyzed using IBM SPSS Statistics, applying descriptive statistics and analysis of variance (ANOVA). RESULTS: Of the participants, 276 (65.6%) had used antibiotics in the past year. Notably, 207 (49.2%) reported buying antibiotics without prescriptions, and 189 (44.9%) used leftovers for common illnesses. Educational level was significantly associated with usage frequency (p < 0.0001). Knowledge scores showed no significant demographic differences, while AMR awareness increased significantly with age (p < 0.0001). Furthermore, 226 (53.7%) took antibiotics for colds or sore throats, and 214 (50.8%) stopped treatment once they felt better. CONCLUSION: Widespread ASM and persistent misconceptions highlight the urgent need for targeted behavioral and regulatory interventions in primary care.