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Category: Volume 10 Issue 02 February 2022
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Title: The role of Antibiogram in the evaluation of Anti-Microbial Stewardship Program in present South India

Authors: Sheeba K Thomas, Shoba Kurian Pulikottil

 DOI: https://dx.doi.org/10.18535/jmscr/v10i2.17

Abstract

Even though there are opinions that the antibiogram is intrinsically flawed and it needs to address multiple confounders, nevertheless the general consensus in that the antibiogram continues to remain as a consistent measurable unit of the effectiveness of Anti-Microbial Stewardship Programs in contributing to patient care. Antimicrobial resistance was predicted even by Alexander Flemming himself to Penicillin. Therefore, almost in every centre, the measures and strategies in antimicrobial stewardship program address primarily how to decrease the problems created by antibiotic resistance. The experience with trying to decrease the use of fluoroquinolones following rampant resistance only resulted in increased use of and subsequent resistance to Carbapenems. This phenomenon of ‘squeezing the balloon’ ought not to be repeated. Although all agree that appropriate antibiotic use definitely brings down financial burden on the patient, how far it helps in actually bringing down the length of hospital is still not clear. Measuring the conservable days of therapy is supposed to give a clearer picture. It is also agreed that the rate of hospital acquired infection by multiple drug resistant organisms is more useful than calculating the proportion of resistant isolates. Finally, the important recommendation for India is to implement a uniform hospital antibiotic policy and ensure faithful adherence. There is a need to agree on a uniform method of antibiotic susceptibility testing in all hospital microbiology laboratories that also includes testing of resistance of higher drugs. Rapid PCR testing of MRSA versus MSSA (methicillin resistant versus sensitive Staphylococcus aureus) would be useful in blood culture. Quality control and assurance programs need to be set up.

Keywords: AMSP Antimicrobial Stewardship Program, AMR Antimicrobial resistance, Antibiogram.

References

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Corresponding Author

Sheeba K Thomas

Assistant Professor, Department of Microbiology, Government Medical College, Kottayam, Kerala, India