Kerala achieves milestone in AMR control efforts

The State has achieved a milestone in its antimicrobial resistance (AMR) control efforts with 83 hospitals in the State earning the status of antibiotic-smart hospitals and five panchayats being declared antibiotic-literate panchayats, having fulfilled all prescribed criteria for the same.

Among the 83 antibiotic-smart hospitals, 73 are primary care-level hospitals, four secondary-level hospitals, and one tertiary-level hospital.

These institutions were declared antibiotic-smart after a rigorous evaluation process conducted at the institutional, block, district, and State levels to verify that the prescribed standards were met.

Under the Kerala Antimicrobial Resistance Strategic Action Plan (KARSAP), the State had conceptualised the ideas of antibiotic smart hospitals and antibiotic-literate local self-government institutions, as part of strengthening antimicrobial resistance control initiatives.

Comprehensive operational guidelines had been issued to implement the programme, based on which the accreditations were awarded.

Antibiotic-smart hospitals

Antibiotic-smart hospitals are health-care institutions which implement a pragmatic model of antimicrobial and diagnostic stewardship while ensuring compliance with standard infection prevention and control (IPC) practices.

These hospitals act as a source of continuous ‘information, education, and communication’ (IEC) activities to health care workers and the public thereby fostering participatory stewardship.

Some of the criteria include display of posters on AMR in Malayalam, posters on AwaRe (Access, Watch, Reserve) classification of antibiotics which guide rational use of antibiotics, regular awareness sessions for public and quarterly prescription audits.

About 95% of antibiotics used in outpatient departments (OPD) in primary care hospitals should be from the Access category (broad-spectrum antibiotics used for common infections with lower resistance risk), whereas for secondary care it is 90% and tertiary care 85%. In all levels of hospitals, out of the total antibiotics prescribed, 60% should be from the Access category.

In secondary and tertiary care hospitals, functional infection control committees and antimicrobial stewardship committees are a must. If more than two antibiotics are combined or if antibiotics are continued for more than seven days, the reason for the same has to be documented. Hospital infection control committee should perform surveillance with regard to ‘healthcare associated infections (HAIs).

Antibiotic-literate panchayats

The concept of antibiotic-literate panchayats has been introduced by the State based on the One Health approach. The panchayats that have achieved this distinction are Kakkodi, Panavally, Thakazhy, Viyapuram, and Chettikulangara.

The first tertiary-level antibiotic-smart hospital is Ernakulam General Hospital. The secondary-level hospitals to achieve the distinction are Fort Kochi taluk hospital, Chengannur district hospital, Alappuzha district hospital, and the Women and Children hospital, Alappuzha.

Efforts are on to transform all hospitals and LSGs in the State into antibiotic-smart institutions in a time-bound manner, Health Minister Veena George, said here.