Ethical use of AI in infectious diagnostic decision and therapeutic stewardship

Artificial intelligence (AI) is rapidly reshaping healthcare, offering transformative potential in infectious diagnostics and antimicrobial stewardship through enhanced accuracy, efficiency, and predictive capabilities. However, its integration into clinical practice raises significant ethical challenges. These include transparency of decision-making, protection of patient privacy, algorithmic fairness, accountability, and the preservation of human oversight. Global and national bodies have developed guidance to address these concerns: the World Health Organization (WHO) emphasizes autonomy, inclusiveness, and equity; the U.S. Food and Drug Administration (FDA) regulates adaptive AI as medical devices; the European Union AI Act classifies medical AI as "high-risk"; and the Indian Council of Medical Research (ICMR) highlights accountability, data security, and cultural sensitivity. Drawing on these frameworks, this perspective discusses the ethical imperatives of deploying AI responsibly in infectious diagnostic and therapeutic stewardship. Best practices are outlined to ensure that innovation enhances patient trust, safety, and equity while mitigating risks of misuse or bias.