Challenges Facing in the Implementation of Antimicrobial Stewardship in a Tertiary Care Hospital

Antimicrobial resistance (AMR) is a critical threat to public health around the world, and it is becoming more prevalent. India is the nation that uses the most antibiotics globally and has the highest incidences of infectious diseases. The scoping report on antimicrobial resistance in India indicated that more than 70% of the isolates of Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii, and almost half of all Pseudomonas aeruginosa, were resistant to fluoroquinolones and third generation cephalosporins. The emergence of resistance in India has been attributed in important part to the unregulated over-the-counter availability of antibiotics and non-compliance with the recommended treatment duration. The other possible reasons for the emergence of resistant pathogens are antibiotic misuse, overuse, and self-medication. Antibiotic overuse in India has been reported by various studies.