District-Level Antibiogram Initiative to Combat Antibiotic Overuse

Kerala has spearheaded a pioneering initiative by introducing district-level antibiograms to tackle the issue of antibiotic overuse. Implemented through a robust hub-and-spoke model under the Kerala Antimicrobial Resistance Strategic Action Plan (KARSAP), this endeavor aims to curb the indiscriminate use of antibiotics. The inaugural release of the antibiogram took place in the Ernakulam district.This project sets its sights on extending the reach of antibiograms to all districts in the state in the forthcoming years. The practice of dispensing antibiotics in distinctive blue packaging, a measure pioneered in the Ernakulam district, will now be standardized statewide. Furthermore, Kerala has established Antimicrobial Resistance (AMR) committees across all districts and blocks, marking a pioneering effort in the nation. The fruition of these endeavors is evidenced by the release of the Ernakulam district's Antibiogram.Under this initiative, a network of laboratories has been established following a hub-and-spoke model in 11 districts. While the KARSAP Antibiogram, released annually via the KARS NET network, previously focused on studying AMR patterns in tertiary hospitals, the introduction of district-level antibiograms facilitates a deeper understanding of AMR trends in primary and secondary healthcare settings.Efforts to combat AMR extend beyond human health to encompass animal husbandry, fisheries, aquaculture, and the food sector. Mandating the display of posters in all medical stores emphasizing that antibiotics should only be dispensed with a doctor's prescription is a key component of this initiative. Additionally, Antibiotic Smart Hospitals will be recognized with a special emblem and certificate. Operation Amrit, implemented by the Drug Control Department, represents a crucial scheme aimed at curbing antibiotic overuse.The misuse of antibiotics extends beyond human consumption to encompass areas such as animal husbandry, poultry farming, and fish farming. Concerningly, instances of antibiotic resistance have been identified in environmental samples, highlighting the urgent need for concerted action to address this multifaceted challenge.