Amrita Institute of Medical Sciences, Amrita Vishwavidyapeetham, Kochi, India.
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK.
Antimicrob Resist Infect Control. 2021 Feb 11;10(1):32. doi: 10.1186/s13756-020-00873-9.
The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat.
Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels.
Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.
全球对抗微生物药物耐药性（AMR）的关注度正在不断提高。中低收入国家（LMICs）正处于这一日益严重的公共卫生威胁的中心，政府和医疗保健组织在实施应对 AMR 的行动计划方面处于不同阶段。印度南部的喀拉拉邦是印度最早实施应对这一公共卫生威胁的战略和优先活动的邦之一。
通过所有医疗保健相关学科以及来自公私部门的专业协会的共同努力和协作，喀拉拉邦公私合作伙伴关系（PPP）成功实施了一项全州范围的战略来应对 AMR。该战略采用了多层次的战略领导模式和多层次的实施方法，包括制定全州范围的抗生素临床指南、修订研究生和本科医学课程，以及涵盖全州所有全科医生的培训计划。PPP 被证明是确保全州范围内实施 AMR 行动计划的成功模式。多专业小组的协作工作确保了基于疾病的临床治疗指南和全州范围的感染预防政策的共同设计和制定。通过国际和国家平台以研讨会形式进行知识交流，分享最佳实践，对成功至关重要。公共和私营机构的能力建设包括解决从初级保健到三级保健机构的合理抗生素处方实践和各级感染预防方面的实际和本地障碍。
通过 7 年的利益相关者参与、与政府的游说以及通过共同制定和实施推动变革，PPP 成功地在全州范围内实施了抗菌药物管理计划。喀拉拉邦 PPP 战略 AMR 计划的实施路线图可以为其他旨在实施 AMR 行动计划的邦和国家提供借鉴。
