Behavioural Changes Towards AMSP

A global issue regarding public health is Antibiotic resistance is often cited as "the silent tsunami facing modern medicine".[1] Antibiotics were among the valuable discoveries in modern medicine that are lifesaving in severe infections. Antibiotics used for trivial infections and viral infections have led to the emergence of resistance. Although most practitioners understand the risks of antimicrobial resistance the fear of "getting it wrong" supersedes this risk.[2] This could be mostly because of the medical practitioners being under pressure for faster solutions and also because of the commercial interest of the pharmaceutical industries. Antimicrobial stewardship programs (AMSP) should be of priority in such situations which rationalize the use of antimicrobials in the hospital. Dedication, liability, ability to choose the correct medication, appropriate action, tracking, reporting, and education are the different elements that lead to the successful implementation of AMSP.[3] AMS along with patient safety and infection prevention and control (IPC) are part of the holy trinity that is strengthening health systems.[4] Antibiotic usage should be limited to bacterial infections, targeting the specific pathogen, given in the optimal dosage which increases patient compliance and leads to a decrease in the development of resistance. Antibiotic cycling and scheduled antibiotic switching, use of newer rapid molecular methods along with conventional methods to guide de-escalation from a broad spectrum to narrow spectrum drug may transiently decrease selective pressure and thereby resistance. The dosage of antibiotics has to be optimized by taking into consideration the individual patient, causative organism, site of infection, and PK-PD characteristics.[5] The use of biomarker-based algorithms and local antibiograms aids in reducing unnecessary antimicrobial exposure.[2] This can be achieved by an actively functioning antimicrobial stewardship team. Stakeholders of the team especially critical care practitioners and clinical microbiologists are the ideal fit for this to integrate AMSP to significantly reduce unwarranted antimicrobial exposure based on targeted therapies and antimicrobial decision-making in real-time. Antimicrobial stewardship should be a behavioral change within the person. Hence, acceptable motivational education is a must to bring in such a change. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.