Antimicrobial stewardship program: Fighting antimicrobial resistance in India

Abstract

Antimicrobial resistance (AMR) is a significant concern in India, contributing to increased medical costs, prolonged hospital stays, and mortality. Antimicrobial stewardship programs (AMSP) are organizational strategies in health-care systems designed to promote, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness. The Indian council of medical research recognizes the need for AMS structures in healthcare institutions and has initiated actions to support this. These include developing an AMS curriculum, conducting workshops for increased awareness and education, and expanding surveillance of antimicrobial usage and resistance trends. However, many hospitals in India still lack structured processes for AMS, requiring a multidisciplinary approach involving various experts. AMSP contribute significantly to improving antibiotic use without compromising patient outcomes, such as optimal selection of agents, correct dosing, appropriate administration routes, and proper therapy duration. The aim is to enhance patient care and outcomes, reduce infection complications, and minimize the emergence of AMR. Key challenges faced in implementing AMS programs in India include lack of infrastructure and personnel, limited resources and funds, limited laboratory capability, absence of antibiotic prescription policy, irrational prescription and excessive use of broad-spectrum antibiotics, self-medication, inappropriate disposal of leftover antibiotics, lack of regulation, and treatment non-compliance. These challenges necessitate robust, collaborative, and multifaceted responses, including policy reform, investment in infrastructure development, expanded surveillance, improved professional practices, and public education.