Abstract
BACKGROUND: Antimicrobial resistance (AMR) constitutes a formidable global health threat, spanning bacterial, viral, and fungal pathogens. Within this broader context, antibiotic resistance (ABR)—specifically the resistance of bacterial pathogens to antibiotic agents—is the primary focus of this investigation, as it is most directly influenced by community-level knowledge and practices (KP). METHODS: This study employed a cross-sectional survey of 200 participants in Damascus, Syria, to explore the relationships between sociodemographic characteristics and knowledge, attitudes, and practices (KAP) regarding antibiotic use. However, given the cross-sectional nature of the study, the observed relationships are interpreted as associations rather than causal effects. RESULTS: The findings highlight patterns of antibiotic-related KP among surveyed residents in Damascus and suggest areas where educational and public health initiatives may be beneficial. Our data reveal generally high adherence to prescribed antibiotic courses alongside ongoing behaviors such as self-medication and antibiotic reuse, reflecting persistent gaps in awareness and access barriers. Observed associations between education level, gender, and age with responsible antibiotic behaviors suggest that social determinants may serve as important correlates of health practices within this sample. By exploring community-level factors associated with antibiotic use in a Damascus-based sample, this research provides descriptive data that may help inform the development of local educational initiatives tailored to this specific context. CONCLUSIONS: This exploratory study provides preliminary evidence connecting social and demographic variables to self-reported antibiotic misuse, contributing to the available data regarding antibiotic use behaviors within a specific urban context in Syria and highlighting the utility of behavioral science frameworks as conceptual lenses for future public health interventions to combat AMR effectively. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-27053-5.