Rationalantimicrobial Use in Obstetrics: A Review of Current Practices, Resistance Challenges, and Surveillance Gaps in India

Antimicrobial resistance (AMR) in obstetric infections poses a critical threat to maternal and neonatal health, particularly in low-resource settings. Rising resistance among common pathogens in pregnancy-related infections complicates treatment, increases maternal morbidity, and contributes to neonatal sepsis. This review synthesizes current practices in antibiotic use, highlights global and Indian guidelines, and identifies surveillance and stewardship gaps. Despite policy frameworks from WHO, ICMR, and national programs, real-world implementation is limited due to inadequate microbiological capacity, lack of hospital-specific antibiotic policies, and insufficient data integration. Strengthening local surveillance, promoting antibiotic stewardship, and enforcing routine screening for asymptomatic bacteriuria and group B Streptococcus (GBS) are essential. This narrative review underscores the urgent need for scalable, technology-integrated AMR strategies tailored to resourceconstrained maternal healthcare systems.