ISSN: 0973-7510

E-ISSN: 2581-690X

Research Article | Open Access
Aparna Chakravarty1, Nusrat Nabi2 , Rituparna Basu3, Priyanka Gupta4, Dina Raja5, Rupshikha Dutta6 and Nilam Nigam7
1Department of Pediatrics, Hamdard Institute of Medical Science and Research, New Delhi – 110 029, India.
2Department of Pharmacology, Hamdard Institute of Medical Sciences and Research, New Delhi – 110 029, India.
3Department of Anatomy, Bankura Sammilani Medical College, Bankura – 722 102, West Bengal, India.
4Department of Pediatrics, ESIC Medical College, Faridabad – 121 001, Haryana, India.
5Department of Microbiology, Guwahati Medical College and Hospital, Guwahati – 781 032, Assam, India.
6Department of Anatomy, Prathima Institute of Medical Sciences, Karimnagar – 505 415, Telangana, India.
7Department of Pharmacology, Rama Medical College Hospital and Research Centre, Kanpur – 208 001, Uttar Pradesh, India.
J Pure Appl Microbiol. 2022;16(2):1049-1059 | Article Number: 7582 | © The Author(s). 2022
Received: 30/01/2022 | Accepted: 01/04/2022 | Published online: 17/05/2022
Issue online: June 2022

Antimicrobial stewardship (AMS) and appropriate infection prevention practices are essential to decrease the rising trend of antimicrobial resistance (AMR). Good antimicrobial prescribing habits formed early in the medical career can make a paradigm shift in combating the menace of AMR. Scarce data is available about the knowledge and perceptions of Indian undergraduates on AMS. This study was planned to analyse the knowledge, attitude and perceptions (KAP) of Indian medical undergraduates on rational antimicrobial prescribing, so that the lacunae in the training curriculum can be identified and addressed effectively. A cross-sectional questionnaire-based survey was carried out, on the pre-final and final year medical students (6th to 9th semester) from six medical colleges across different states of India. A scoring system was used to rate the knowledge, attitude and perceptions of the respondents as poor, average, or good. A total of 1505 students (83.61%) participated in the survey. Majority of the students (81.7%) from all medical colleges favoured more education on antimicrobials and to incorporate AMS in the undergraduate curriculum through integrated teaching. The results showed that overall, 70.9% students had a “good” score for knowledge on antimicrobial use, whereas only 55% scored “good” for being confident in rational antimicrobial prescribing. Surprisingly, only 56.5% correct responses for knowledge on selection of broad-spectrum antibiotics over narrow-spectrum antibiotics were recorded in our study. Most of the students (79.9%) were conscious that irrational prescribing can result to AMR. On the other hand, 54.9% students believed that the supply of new antimicrobials would take care of AMR eventually. 78.1% of our students believed that they were confident in making the right diagnosis of infection, whereas, 63.7% of respondents believed that they were not confident in identifying the clinical scenarios where antibiotics are not required. Significant association (p<0.05) was seen for both “good” knowledge and perception scores with the higher academic semesters reflecting more clinical exposure in later in course semesters. The study has highlighted the areas of clinical weakness and dilemma regarding prescription of antimicrobials. Efforts to address these issues on basic principles of antimicrobial stewardship, is critical for laying the foundation of successful AMS program and contributing in overcoming the antimicrobial resistance. The study recommends targeted training, articulating fine details of prescribing antimicrobials with real time case scenarios through a multi-disciplinary approach. The Indian undergraduate medical curriculum needs to incorporate early well-structured training on AMS by integrating pharmacology and microbiology teaching with the clinical subjects to ensure appropriate antibiotic prescribing practices by the future prescribers.


Antimicrobial stewardship, undergraduates, curriculum, antimicrobial resistance

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