Ghafur Abdul, Bansal Nitin
Department of Infectious Diseases, Apollo Hospital, Chennai, India.
Department of Infectious Diseases, Rajiv Gandhi Cancer Institute, New Delhi, India.
Transpl Infect Dis. 2022 Oct;24(5):e13854. doi: 10.1111/tid.13854.
We, in India, have unique challenges in implementing antimicrobial stewardship (AMS) in our institutions, especially the transplant settings. Identifying challenges, addressing them, and finding innovative solutions to these are the need of the hour.
Several challenges in India exists, which hamper implementation of effective AMS like lack of adequately trained personnel (infectious diseases [ID] physicians and clinical pharmacists), missing opportunities of AMS during the timeline, and lack of India-specific outcome measures for AMS programme.
Finding local solutions can make our AMS implementation more effective. Numbers of ID physicians are increasing (24 in 2011 to >300 in 2020), and we expect the specialty to grow more and make rapid progress in AMS. We propose that cost savings and overall improvement in clinical outcome to be included in outcomes measures, rather than rates of C. difficle infection. Effective implementations of National Medical Commission mandatory AMS training regulation are few such steps that can fill the gaps.
Antimicrobial stewardship programs is one of the several components of tackling the antimicrobial resistance-related negative consequences in transplant patients. Transplant physicians, surgeons, and institutions should understand the bigger picture and strive hard to convince the policymakers to act for the benefit of the transplant recipients and the transplant programs across the country.
在印度，我们的机构在实施抗菌药物管理（AMS）方面面临独特挑战，尤其是在移植环境中。识别挑战、应对挑战并找到创新解决方案是当务之急。
印度存在若干挑战，阻碍了有效AMS的实施，比如缺乏训练有素的人员（传染病[ID]医生和临床药师）、在时间轴上错过AMS机会，以及缺乏针对印度的AMS项目结局指标。
寻找本土解决方案可使我们的AMS实施更有效。ID医生数量在增加（从2011年的24名增至2020年的300多名），我们预计该专业会进一步发展并在AMS方面取得快速进展。我们提议将成本节约和临床结局的整体改善纳入结局指标，而非艰难梭菌感染率。有效实施国家医学委员会的强制性AMS培训规定是填补这些空白的少数举措之一。
抗菌药物管理项目是应对移植患者中与抗菌药物耐药性相关负面后果的几个组成部分之一。移植医生、外科医生和机构应了解全局，并努力说服政策制定者采取行动，以造福全国的移植受者和移植项目。
