Related Experiment Video
Updated: May 9, 2026
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
Summary
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 systemsMore Related Videos
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