Kerala has taken its Antimicrobial Resistance (AMR) surveillance activities to the district-level by releasing the Standard Operating Procedures (SOPs) for district-level AMR committees.

The criteria for the declaration of secondary and tertiary care hospitals as antibiotic smart hospitals was also released by the Health department on Tuesday.

It is the overuse or irrational use of antibiotics which leads to antimicrobial resistance, a condition wherein microbial organisms develop resistance to drugs which are meant to cure diseases caused by these organisms. AMR is a global threat to human health.

The State has been pioneering AMR surveillance activities to reduce antimicrobial resistance , through a structured, science-based programme, the Kerala Antimicrobial Resistance Strategic Action Plan (KARSAP, formulated in 2018.

AMR committees have been formed in all districts and in all 190 block panchayats in the State.

The district-level AMR committees are the supervisory and implementing body for monitoring and coordinating the AMR activities in a district. The District Medical Officer (Health) will be the chairman and district nodal officer AMR will be the convener of the district-level AMR.

It will be the task of district-level AMR committees to create universal awareness about infection prevention and control practices among the public and health-care professionals/ institutions; awareness about consuming antibiotics only with specific indications and that too on a prescription by a qualified medical officer.

The committees have also been tasked with awareness creation on the importance of safe disposal of unused and date-expired antibiotics/drugs as well as the One Health programme and how crucial it is for controlling AMR.

One of the main tasks of the committees will be to ensure that all hospitals achieve the antibiotic-smart status.

Grading

Hospitals which fulfill certain guidelines-based criteria on restricting the abuse of antibiotics are graded as antibiotic-smart hospitals. All hospitals in the State will be made antibiotic-smart hospitals in phases. The guidelines for making primary care hospitals antibiotic smart, are already in place.

The guidelines direct that AMR awareness posters in Malayalam be displayed clearly in all hospitals and that all health workers and medical students be given training in reducing the abuse of antibiotics. Hospitals are directed to conduct prescription audits once every three months.

The infection prevention and control committees and antimicrobial stewardship committees should meet and review AMR activities regularly.

WHO surgical safety checklist should be implemented in the hospital by all surgical units. The PROUD initiative for proper disposal of date-expired and un-used antibiotics should be implemented in hospitals.

Hospital infection control committee should perform surveillance with regard to Healthcare Associated Infections (HAIs) like surgical site infections, catheter associated urinary tract infections, central line associated infections etc.

The sewage treatment plants and effluent treatment plants in the hospitals should function as per the guidelines of the Pollution Control Board.