Related Experiment Video

Updated: May 9, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Standard Treatment Workflows: scaling system-compatible approaches to rational antibiotic use

Hitesh K Sharma1, Ravinder Singh1, Dhiraj Kumar1

  • 1Indian Council of Medical Research, New Delhi, India.

Frontiers in Medicine
|May 8, 2026
PubMed

Insights

India

Area of Science:

  • Infectious Diseases
  • Public Health
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) is a significant global health threat, particularly impacting resource-constrained health systems.
  • India faces a severe AMR burden, with high rates of carbapenem resistance in key pathogens like Klebsiella pneumoniae and Acinetobacter baumannii.
  • Challenges in antibiotic prescribing in India include high patient volumes, limited diagnostics, and inconsistent adherence to treatment guidelines.

Purpose of the Study:

  • To evaluate the Indian Council of Medical Research's (ICMR) Standard Treatment Workflows (STWs) for antimicrobial stewardship.
  • To assess the stewardship orientation, system compatibility, and scalability of STWs for rational antibiotic use.
  • To inform the wider adoption of STWs in India and similar high-burden health systems.

Main Methods:

  • A review of 157 STWs covering conditions requiring antibiotic therapy was conducted.
  • Recommended antibiotic agents in STWs were mapped against the WHO AWaRe classification, National List of Essential Medicines (NLEM), and Indian Public Health Standards (IPHS).
  • The alignment of STWs with stewardship principles and existing health system capacities was examined.

Main Results:

  • Recommended antibiotics in the STWs primarily belong to the WHO Access category.
  • The majority of recommended agents are included in India's National List of Essential Medicines (NLEM).
  • STWs demonstrate strong alignment with antimicrobial stewardship principles and existing health system infrastructure.

Conclusions:

  • ICMR Standard Treatment Workflows are a stewardship-aligned and system-compatible tool for guiding antibiotic use.
  • STWs show strong readiness for large-scale implementation across India's healthcare settings.
  • The adoption of STWs is recommended for India and relevant for other health systems facing significant AMR challenges.
Keywords:
Standard Treatment Workflowsantimicrobial resistanceantimicrobial stewardshipclinical guidance scalinghealth systems

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