Antimicrobial resistance, as a phenomenon, is the culmination of a complex evolutionary process that occurs within the challenging milieu of microorganisms. It is the result of genetic changes or adaptations that arise as a response to the selective pressures exerted by antimicrobial agents. This lead to the restricted used of antibiotics as novel antibiotics development and use is not widespread . As we are aware, the current gold standard methods for antimicrobial susceptibility testing (AST) are notoriously laborious, often requiring extended periods of time to generate results that are not readily available within a single working day. Consequently, healthcare practitioners may resort to broad-spectrum antimicrobial agents as an initial intervention while awaiting the laboratory's results from antibiogram testing to guide the selection of a more tailored antimicrobial therapy. This approach, while expedient, is not without its limitations, and can contribute to the rise of antimicrobial resistance as well as lead to a host of adverse outcomes for patients. As such, there is a pressing need for the development and implementation of more efficient and reliable AST methods that can deliver timely and accurate results to support optimal antimicrobial prescribing practices . In addition, it is imperative that stringent limitations be placed on the accessibility of antibiotics to populations in developing nations. This is yet another influential element in the proliferation of antimicrobial resistance; however, this issue lies outside the purview of this review. When conducting a gold standard antimicrobial susceptibility test (AST), phenotypic methods are frequently favoured as the initial approach in routine clinical laboratory evaluations. This preference is due to the fact that these methods offer a more comprehensive understanding of antibiotic resistance, and can assist in directing treatment options by providing minimum inhibitory concentration measurements that can be correlated with achievable serum levels. A comprehensive examination of the assay for gold standard phenotypic and genotypic antimicrobial susceptibility testing is beyond the purview of this review. I would recommend consulting the works of Alex van Belkum et al and Kira J. Fitzpatrick et al , as they offer comprehensive coverage of these techniques in the literature. Typically, the onset of infection arises from the successful adaptation of a pathogen within the host cells and normal microflora through the secretion of virulence factors. This results in the manifestation of symptoms that can aid in the dissemination of the disease. The identification of pathogens responsible for infections can be achieved through various microbiological tests, such as direct detection and culture. Microscopy-based direct detection is generally preferred for detecting pathogens that are difficult to culture, such as N. gonorrhoeae and M. leprae. Conversely, culture-based techniques are used for detecting and characterizing samples containing pathogens. While in vivo and ex vivo culture methods exist, in vitro culture utilizing artificial media is commonly employed as a definitive identification technique to determine antimicrobial susceptibility and for epidemiological studies. Antimicrobial susceptibility testing is designed to observe inhibited microbial growth in the presence of antimicrobial agents, which can either be bacteriostatic (causing reversible inhibition) or bactericidal (causing death). The clinical and laboratory standard institute or the European Committee on Antimicrobial Susceptibility Testing provides guidelines and thresholds for the determination of minimum inhibitory concentration (MIC). However, it is important to note that antimicrobial susceptibility testing is a probabilistic process as the relationship between MIC and clinical pharmacodynamics/pharmacokinetics for each case is complex and often does not