Awareness on Antimicrobial drug resistance and Antimicrobial Stewardship Programme among Undergraduate and Postgraduate Students in a Teaching Hospital

Background: Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death.As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. In India, where antibiotic misuse is widespread, future prescribers must possess strong knowledge of AMR and antimicrobial stewardship programmes (ASP) to promote rational antimicrobial use.

Objective: To evaluate awareness and knowledge of AMR and ASP among undergraduate and postgraduate medical students at a teaching hospital in Telangana, India.

Methods: A prospective cross-sectional online survey was conducted using a 16-item questionnaire adapted from the WHO 2015 AMR Multi-Country Public Awareness Survey, with additional ASP-specific questions. The study included 662 voluntary participants (602 undergraduates across all MBBS years and interns, 60 postgraduates) from a tertiary care teaching hospital in Telangana, India. Knowledge was scored out of 16 (1 point per correct answer; partial credit for multi-correct items only if all options selected). Data were analyzed using descriptive statistics, one-way ANOVA for year-wise differences, and chi-square tests.

Results: The overall mean knowledge score was 9.01 ± 2.82 (56.3% correct). Scores increased progressively with academic year: first year (7.00 ± 2.5), second year (8.00 ± 2.6), third/fourth year and interns (10.00), and postgraduates (11.00 ± 2.3) (ANOVA F=48.15, p<0.0001). Only 45% of participants had heard of ASP, with correct identification of its functions (~40%) and team composition (~30%) remaining low, though improving across years (p<0.0001). Notably, 80% expressed willingness to educate family and friends about AMR.

Conclusion: Medical students demonstrated moderate AMR knowledge that improved with clinical exposure, but awareness of antimicrobial stewardship remained limited, particularly among early-year undergraduates. These findings underscore the need for early, structured integration of ASP training into the medical curriculum to equip future physicians to combat AMR effectively in high-burden settings like India.