ABSTRACT
Antimicrobial resistance (AMR) has become a major global health challenge, with the potential to make previously treatable infectious diseases life-threatening once again. Although antimicrobials were once celebrated as “miracle drugs,” the slow pace of new antibiotic development and the rapid rise of resistant bacterial strains has created an urgent need for robust antimicrobial stewardship. Despite having strong pharmacological foundations, many medical students and interns find it difficult to translate stewardship principles into everyday clinical decision-making. Several socio-economic and systemic factors, including patient expectations for immediate relief and easy over-the-counter access to antibiotics influence this gap. In many instances, patients perceive antibiotic prescriptions as a sign of effective treatment, thereby increasing pressure on clinicians to prescribe them unnecessarily. AMR arises through both intrinsic and acquired mechanisms, with horizontal gene transfer playing a vital role in speeding up the spread of resistance among bacterial populations. In this context, medical students form a crucial group of future antimicrobial stewards. Bridging the gap between knowledge and practice requires more than theoretical instruction; it also involves addressing the sociocultural factors that influence antibiotic misuse. Effective strategies should incorporate multidisciplinary stewardship efforts and encourage changes in both prescribing habits and patient expectations to preserve the effectiveness of current antimicrobial therapies. This paper examines the “ground-zero” landscape of AMR, particularly in the Indian healthcare setting, where a noticeable gap persists between theoretical knowledge and its application in clinical practice. 

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