Under-explored Dimensions of Anti-microbial Stewardship in India.

Antimicrobial resistance accounts for the greatest threat to the health system. The most appropriate path to mitigate this menace is a collaborative, multidisciplinary approach combining antimicrobial stewardship with infection prevention. Sustainable efforts to overcome this global problem would require awareness, learning and coordination at various levels in the health system. Government policies, national guidelines, collaborative functioning in research, online training modules, and media have an important role in combating the threat. We recommend a multipronged approach involving the infection control specialist, as well as various cadres of health-care providers, including pharmacists, the nurses and community-level health workers. We also recommend that all health-care professionals prescribing antibiotics take responsibility and understand the adverse consequences of inappropriate and suboptimal antibiotic usage. Certain countries in the world have already in place the antimicrobial stewardship programme with multi-disciplinary approach. India needs to have a strengthened anti-microbial stewardship programme involving all cadres of health-care providers.