Public Knowledge, Practices, and Acceptance of Smart Health Technologies Addressing Antibiotic Use and Resistance in...

Background: Antimicrobial resistance (AMR) remains a major global public health threat, largely driven by inappropriate antibiotic use. Smart health technologies (SHTs), including mobile health applications and digital stewardship tools, offer promising opportunities to improve antibiotic use and strengthen antimicrobial stewardship. This study assessed public knowledge, practices, and stated acceptance of selected SHTs related to antibiotic use and AMR management among adults residing in Saudi Arabia. Methods: A cross-sectional online survey was conducted among adults residing in Saudi Arabia between November 2025 and January 2026 using a structured questionnaire assessing knowledge and practices related to antibiotic use, awareness of SHTs, perceived barriers, and acceptance of digital health technologies. Descriptive and inferential statistical analyses were performed. Results: A total of 434 consenting participants were included in the final analysis. Participants demonstrated gaps in knowledge of antibiotic use and AMR, while misconceptions and inappropriate practices remained common, including lifetime non-prescription antibiotic use (37.8%) and sharing antibiotics (31.3%). Awareness of SHTs was limited, with only 30.4% aware of antibiotic-related mobile health applications. Despite limited awareness, 61.8% were willing to use medication-reminder applications and 87.3% preferred electronic prescriptions. The mean acceptance score was 4.39 ± 0.66/5, and 79.7% had high stated acceptance. In an exploratory adjusted analysis, female respondents had higher odds of meeting the predefined high-acceptance threshold (AOR = 1.88, 95% CI: 1.04-3.40); however, this finding should be interpreted cautiously because the overall regression model was not statistically significant and showed modest discrimination. Perceived barriers were not independently associated with acceptance. Conclusions: Despite gaps in knowledge and persistent inappropriate antibiotic-use practices, the surveyed online respondents demonstrated favorable stated attitudes toward selected smart health technologies. These findings should not be interpreted as evidence of actual adoption or national implementation readiness. Further nationally representative and prospective studies are required before broader implementation can be recommended.