Assessment of Knowledge and Awareness Among Clients Attending Primary Health Care Centers Regarding the Use of Non-Prescription Antibiotics in Iraq

Background: Inappropriate use of antibiotics, particularly non-prescription use, is a major global public health challenge, especially in developing countries, and plays a significant role in the emergence of antimicrobial resistance. This study aimed to assess the level of knowledge and awareness among clients of primary health care centers regarding the risks of non-prescription antibiotic use and its association with sociodemographic characteristics. Methods: This descriptive cross-sectional study was conducted among 200 clients attending eight primary health care centers in Al-Diwaniyah Province, Iraq, between January 18 and February 1, 2026. Participants were selected using convenience sampling. Data were collected באמצעות a structured questionnaire adapted from the Antibiotic Knowledge and Consumption Tool (AKCT) and analyzed using SPSS version 26. Descriptive statistics and inferential analyses, including multiple linear regression, were applied. Results: The mean knowledge score was 0.50 ± 0.18, indicating a moderate level of knowledge, while the mean awareness score was 0.77 ± 0.18, reflecting a relatively high level of awareness among participants. Several misconceptions were identified, including the use of antibiotics for viral infections and premature discontinuation of treatment. Educational level was the strongest predictor of both knowledge (β=0.448, p<0.001) and awareness (β=0.439, p<0.001). Income was identified as a significant predictor of awareness (β=0.229, p=0.001). Conclusion: Despite a relatively acceptable level of awareness, sufficient knowledge regarding optimal antibiotic use was not identified. Therefore, implementing targeted educational interventions and strengthening regulatory policies on non-prescription antibiotic dispensing appear necessary to reduce antimicrobial resistance.