Awareness, Knowledge, and Attitude (AKA) of government secondary school students on the use of antibiotics in Shah Alam, Malaysia

  • Widiasmoro Selamat NeniEmail author
  • Gaiyathre Subrain
  • Mohammad Sarimie Nurul-Nizam Shamshir Khan
  • Kenneth Paul Martinez
  • Titinun Auamnoy
Original Article



This study aimed to: (1) assess the socio-demographic characteristics and awareness, knowledge, and attitude (AKA) on the use of antibiotics among government secondary school students, (2) compare the means of AKA based on age, and (3) predict the relationship between AKA domains.

Subjects and methods

A cross-sectional study was conducted involving government secondary school students aged 13, 14, and 16 years old from two secondary schools in Shah Alam, Malaysia.


A total of 136 respondents (mean age = 14.46 ± 1.29 years; female = 63.2%; Malay = 92.6%; urban area = 95.6%) was recruited. Overall, attitude was reported as high (0.68 ± 0.15), but awareness (0.46 ± 0.14) and knowledge (0.51 ± 0.10) were moderate. Significant differences were detected between students aged 13 and 16 years in knowledge (p = 0.003) and total AKA (p = 0.011). Knowledge was significantly associated with attitude (r = + 0.278, p = 0.001) and age (r = + 0.292, p = 0.001), while age significantly correlated with attitude (r = + 0.159, p = 0.039).


This study may serve as a preliminary insight on the development of an effective educational intervention to improve AKA of antibiotic usage.


Awareness Knowledge Attitude Antibiotics Adolescence 



We would like to acknowledge and thank all the institutions involved in this study: Research Management Center (RMC), Management & Science University (MSU), Shah Alam, Malaysia Ministry of Education, Selangor State Office of Education, and the staff and students from the Sekolah Menengah Kebangsaan Alam Megah I and Sekolah Menengah Kebangsaan Alam Megah II schools.

Compliance with ethical standards


Before performing the study, ethical approval was obtained from Kementerian Pendidikan Malaysia (reference: KPM.600-3/2/3-eras (246)) and Jabatan Pendidikan Negeri Selangor (reference: JPNS.PPN 600-1/49 JLD.79 (30)) via online application. Prior to that, the selected schools were approached to explain the intention of the study and the period involved.

Informed consent

Participation was with parental consent, voluntary, and without compensation. Along with a confidentiality statement, the background and intention of the study were explained verbally, and the participants were encouraged to perform without any undue pressure.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Widiasmoro Selamat Neni
    • 1
    Email author
  • Gaiyathre Subrain
    • 1
  • Mohammad Sarimie Nurul-Nizam Shamshir Khan
    • 1
  • Kenneth Paul Martinez
    • 1
  • Titinun Auamnoy
    • 2
  1. 1.Faculty of Health & Life SciencesManagement & Science UniversityShah AlamMalaysia
  2. 2.Faculty of Pharmaceutical SciencesBurapha UniversityChonburiThailand

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