Resistance to antimicrobial agents has increased for reasons relating to the use and misuse of antimicrobials in
human, agriculture and aquaculture. Antimicrobial use is quite high during mass gatherings such as the Hajj pilgrimage.
To reduce non-prescription use and inappropriate prescribing of antimicrobials, a more thorough understanding of their
use and the motives behind why patients request, even demand, antimicrobials, fail to adhere to the prescription is important.
Therefore, we conducted a knowledge, attitude and practice (KAP) survey among Australian Hajj pilgrims in Mecca
during Hajj 2013 using an anonymous, self-administered questionnaire concerning antimicrobial use. Our sample consisted
of 229 adult Australian subjects. Mean age was 42.4 (SD±12.7) years, 178 (77.9%) were male and 80 (34.9%) used
antimicrobials during their stay in Saudi Arabia. Twenty one (26.3%) obtained these in Saudi Arabia without prescription,
and about half (38, 47.5%) brought them from Australia. Of the respondents, 55.8% believed that antibiotics are effective
against viruses, 53.6% thought that antibiotics are effective against common cold and flu, 78.6 % that humans themselves
can become resistant to antibiotics and 75.9% knew that overuse or unnecessary use of antibiotics can cause them to lose
effectiveness. This study has revealed that Hajj pilgrims have inappropriate access to antimicrobials in Saudi Arabia as
well as in Australia. A large scale education campaign and tighter control on prescribing and dispensing of antimicrobials
could improve the appropriate antimicrobial use among Hajj pilgrims.