Background and aims: Antibiotic resistance is increasing globally and regionally, posing a significant public health concern. This study aimed to assess knowledge and attitude toward antibiotic use and the prevalence of self-medication and its association with the knowledge and attitude toward antibiotic use and resistance among private university teachers in Bangladesh.

Methods: This quantitative, cross-sectional study utilized a convenience sampling technique and included 509 respondents. All data were collected using both face-to-face and online versions. Data were collected through both face-to-face and online surveys with all questions in a closed-ended format. Data analysis was conducted using IBM SPSS (version 20), employing frequency analysis, chi-squared tests, and logistic regression.

Results: Among the respondents, 47.9% demonstrated high knowledge of antibiotic use and resistance. Only 19.3% showed a strong positive attitude toward antibiotic use and resistance. Self-medication with antibiotics was reported by 29.0% of respondents. Logistic regression analysis revealed that female participants were 5.02 times more knowledgeable about antibiotic use and resistance than male participants (95% CI: 2.72-9.91; p < 0.001). Additionally, respondents over 40 years old had a 3.71 times higher attitude toward antibiotic use and resistance than those aged 30 or below (95% CI: 1.98-7.06; p < 0.001). Females were 6.79 times more likely to self-medicate with antibiotics compared to males (95% CI: 3.67-13.43), and respondents aged 31-40 were 3.91 times more likely to practice self-medication than other age groups (95% CI: 1.07-3.86). Furthermore, participants with low knowledge and a low attitude toward antibiotic use and resistance were 3.87 times and 4.26 times more likely to self-meditate, respectively, than those who had high knowledge and attitude scores (95% CI: 2.00-5.70 and 95% CI: 1.99-5.12).

Conclusion: To combat antibiotic resistance, campaigns and seminars on responsible antibiotic use should be held at university level. Additionally, enforcement of laws prohibiting unnecessary antibiotic sales in retail pharmacies is essential.