Antimicrobial stewardship programme (AMSP) practices in India

Abstract

A survey was conducted to ascertain practice of antimicrobial stewardship programme (AMSP) in India for 2013. A total of 20 health care institutions (HCI) responded to a detailed questionnaire. All the institutions contacted were tertiary care HCI, of which 12 were funded by government (GHCI) and 8 were corporate/private HCI (PHCI). Further, all catered to both rural and urban populations and were spread across the country. Written documents were available with 40 per cent for AMSP, 75 per cent for hospital infection control (HIC) and HIC guidelines and 65 per cent for antimicrobial agents (AMA) prescription guidelines. Records were maintained for health care associated infections (HCAI) by 60 per cent HCI. Antimicrobial resistance (AMR) data were being analysed by 80 per cent HCI. AMA usage data were analysed by only 25 per cent HCI and AMA prescription audit and feedback by 30 per cent. PHCI performed better than GHCI across all fields of AMSP. The main contributory factor was possibly the much higher level of accreditation of PHCI hospitals and their diagnostic laboratories. The absence of infectious diseases physicians and clinical pharmacists is worrying and demands careful attention.

Antibiotic Use in Pediatric Infections; A Study in Tertiary Care Hospital

“…This is a grossly undesirable situation since antibiotic use guidelines supported through appropriate surveillance is regarded as a fundamental prerequisite for rational antibiotic use [25]. Notwithstanding continuous spread of antibiotic resistance coupled with declining rate of new antibiotic improvement a lot of emphasis is being accorded of late to antibiotic stewardship programs (ASPs) in hospitals [26]. However, although ASPs can be effective in enhancing the quality and safety of antibiotic prescribing for hospitalized patients, there are unique issues relevant to children and pediatric ASPs are still in their infancy [27,28].…”

Antibiotic resistance and its containment in India

“…35 Improving the use of antibiotics Standard treatment guidelines are important to inform healthcare providers about appropriate treatment and prescribing practices for common infections. Treatment guidelines for antimicrobial use have 38 Private institutions were better prepared to respond to antibiotic resistance or outbreaks of healthcare associated infections as they had policies on detection and response. The survey showed weak implementation of some core strategies of antimicrobial stewardship programmes, including restriction of certain classes of drugs and rotation policies for drugs based on current resistance patterns.…”

“…The survey showed weak implementation of some core strategies of antimicrobial stewardship programmes, including restriction of certain classes of drugs and rotation policies for drugs based on current resistance patterns. 38 S t e w a r d s h i p p r o g r a m m e s a n d enforcement vary considerably by institution. The national action plan provides a means to develop uniform requirements for prevention and control of infection and stewardship programmes for healthcare institutions at different AntiMicroBiAl reSiStAnce in South eASt ASiA levels, and to ensure adherence to these guidelines.…”

Antimicrobial stewardship: need of the hour

“…The monitoring and audit of antimicrobial usage is rarity. 32 Antimicrobial resistance and hospital infections have increased alarmingly in India. India is experiencing rising trends of antimicrobial resistance both in hospitals and communities mainly due to rampant overuse and misuse of antibiotics in situations where they are not needed.…”