Knowledge, attitudes, and practices toward antibiotic use and resistance among medical students: a cross-sectional study

Background: Antimicrobial resistance (AMR) is becoming a major global health problem, which is jeopardizing the effectiveness of current antibiotics and causing increasing difficulty in routine clinical care. As future prescribers, medical students must develop strong knowledge, attitudes, and practices (KAP) to ensure effective antimicrobial stewardship (AMS). It explored the knowledge, attitude and practice of Indian undergraduate medical students concerning antibiotics and antimicrobial resistance. Methods: A cross-sectional survey was conducted among 500 undergraduate medical students at a tertiary care hospital attached to a medical college in India. A validated, structured 30-item questionnaire based on World Health Organization (WHO) guidelines was used to assess KAP. The responses were reported using a 5-point Likert scale. Statistical analyses included t-tests, Mann-Whitney U tests, and Welch’s ANOVA to evaluate the influence of AMR training and academic progression (p<0.05). Results: Students demonstrated strong theoretical knowledge of AMR, but reported low confidence and limited engagement in AMS activities. Only 47.6% had formal AMR training, and 16.8% participated in AMS programs. Trained students scored significantly higher in knowledge (p=0.006) but not in attitudes or practices. KAP scores improved progressively across academic years, with final-year students and interns scoring the highest. Conclusions: While Indian medical students show a high awareness of AMR, confidence and practice-oriented engagement are limited. Curricular reforms incorporating experiential learning and early AMS integration are crucial to bridging the knowledge-practice gap.