{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:23:03Z","timestamp":1785424983814,"version":"3.56.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"unspecified","delay-in-days":168,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X26104306_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The rising incidence of antimicrobial resistance (AMR) underscores the urgent need for effective antimicrobial stewardship (AMS). This study assessed the impact of a tailored AMS initiative in Indian hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104306_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An AMS surveillance program was implemented across 11 Indian hospitals (January 2022\u2013June 2023). The intervention (July 2022\u2013June 2023) included hospital-specific antibiograms, antibiotic policy design and implementation, monitoring antibiotic consumption, and tracking multidrug-resistant organisms (MDROs). Hospital staff were trained, and compliance audits with feedback were conducted. Implementation followed the Model for Improvement methodology over 18 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104306_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>AMS surveillance revealed significant improvement in AMS knowledge and practices from the baseline to the postintervention phase. Antibiotic compliance increased from a baseline of 10% to 71% across hospitals, reaching 73%\u201391% in the subsequent period. Surgical prophylaxis compliance improved substantially, particularly in hospitals with initially low adherence. Optimizations in antibiotic selection, dosing, duration, intravenous-to-oral switching, and de-escalation were also observed, resulting in significant compliance gains across all domains. Use of antibiotics classified by the World Health Organization as safer first-line options with a narrow spectrum increased, while use of second- and third-line antibiotics, including those with broader spectra and higher resistance risks, decreased, reflecting a shift toward safer prescribing practices. However, MDRO incidence rates remained variable across sites, showing room for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104306_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Locally tailored AMS interventions within a structured quality improvement framework can establish sustainable practices to mitigate AMR. These findings demonstrate effective strategies for optimizing antibiotic use and provide valuable insights for broader implementation of AMS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2026.10430","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:58:52Z","timestamp":1781773132000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessing the impact of antimicrobial stewardship in low-income healthcare settings: a study of antibiotic use and antimicrobial susceptibility patterns in Indian hospitals"],"prefix":"10.1017","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0974-3542","authenticated-orcid":false,"given":"Ulhas","family":"Vasave","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/024a6d298","id-type":"ROR","asserted-by":"publisher"}],"name":"Americares India Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Paroha","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/024a6d298","id-type":"ROR","asserted-by":"publisher"}],"name":"Americares India Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"S2732494X26104306_ref7","doi-asserted-by":"publisher","DOI":"10.1177\/1559827617700824"},{"key":"S2732494X26104306_ref36","first-page":"e18517","article-title":"Impact of an anti-microbial stewardship program on targeted antimicrobial therapy in a tertiary care health care institute in central India","volume":"13","author":"Garg","year":"2021","journal-title":"Cureus"},{"key":"S2732494X26104306_ref15","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_147_18"},{"key":"S2732494X26104306_ref3","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_2537_21"},{"key":"S2732494X26104306_ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-020-00801-x"},{"key":"S2732494X26104306_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2019.02.020"},{"key":"S2732494X26104306_ref18","unstructured":"18. The Core Elements of Hospital Antibiotic Stewardship Programs: Antibiotic stewardship program assessment tool. 2019. https:\/\/www.cdc.gov\/antibiotic-use\/healthcare\/pdfs\/assessment-tool-p.pdf. Accessed February 12, 2024."},{"key":"S2732494X26104306_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30854-9"},{"key":"S2732494X26104306_ref17","unstructured":"17. CDC. Core elements of hospital antibiotic stewardship programs. Antibiotic prescribing and use, 2024. https:\/\/www.cdc.gov\/antibiotic-use\/hcp\/core-elements\/hospital.html. Accessed October 24, 2024."},{"key":"S2732494X26104306_ref31","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2020-0253"},{"key":"S2732494X26104306_ref28","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11010006"},{"key":"S2732494X26104306_ref8","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics8010007"},{"key":"S2732494X26104306_ref40","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.493904"},{"key":"S2732494X26104306_ref16","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_226_18"},{"key":"S2732494X26104306_ref35","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy290"},{"key":"S2732494X26104306_ref34","first-page":"63","article-title":"A study of antibiotic prescription pattern in patients referred to tertiary care center in Northern India","volume":"5","author":"Kaur","year":"2018","journal-title":"Ther Adv Infect Dis"},{"key":"S2732494X26104306_ref5","volume-title":"Making Healthcare Safer III: A Critical Analysis of Existing and Emerging Patient Safety Practices [Internet]","author":"Gall","year":"2020"},{"key":"S2732494X26104306_ref32","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.4103\/jfmpc.jfmpc_626_19","article-title":"Restricting high-end antibiotics usage - challenge accepted!","volume":"8","author":"Jayalakshmi","year":"2019","journal-title":"J Family Med Prim Care"},{"key":"S2732494X26104306_ref25","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1473_20"},{"key":"S2732494X26104306_ref23","unstructured":"23. Center for Disease Control and Prevention. The Core Elements of Hospital Antibiotic Stewardship Programs. 2019. https:\/\/www.cdc.gov\/antibiotic-use\/healthcare\/pdfs\/hospital-core-elements-H.pdf. Accessed February 12, 2024."},{"key":"S2732494X26104306_ref1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S234610"},{"key":"S2732494X26104306_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2021.100944"},{"key":"S2732494X26104306_ref14","doi-asserted-by":"publisher","DOI":"10.4103\/INJMS.INJMS_118_19"},{"key":"S2732494X26104306_ref22","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00140"},{"key":"S2732494X26104306_ref2","unstructured":"2. CDC. What exactly is antibiotic resistance? Centers for disease control and prevention, 2022. https:\/\/www.cdc.gov\/antimicrobial-resistance\/about\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/drugresistance\/about.html. Accessed July 10, 2023."},{"key":"S2732494X26104306_ref27","first-page":"5","article-title":"Attitude and practices of clinicians, nurses and pharmacists regarding antimicrobial stewardship: a five centre survey from India","volume":"15","author":"Mane","year":"2021","journal-title":"J Clin Diagn Res"},{"key":"S2732494X26104306_ref4","doi-asserted-by":"publisher","DOI":"10.18231\/j.ijmr.2024.020"},{"key":"S2732494X26104306_ref26","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics8010011"},{"key":"S2732494X26104306_ref37","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S265407"},{"key":"S2732494X26104306_ref38","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlaa050"},{"key":"S2732494X26104306_ref33","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00825-16"},{"key":"S2732494X26104306_ref24","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20020996"},{"key":"S2732494X26104306_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmmb.2022.12.011"},{"key":"S2732494X26104306_ref29","first-page":"e51766","article-title":"Impact of raising awareness and providing feedback on compliance to antibiotic prescription guidelines in pediatric inpatients","volume":"16","author":"Hembade","year":"2024","journal-title":"Cureus"},{"key":"S2732494X26104306_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.03.033"},{"key":"S2732494X26104306_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlab135"},{"key":"S2732494X26104306_ref9","unstructured":"9. WHO. The WHO AWaRe (Access, watch, reserve) antibiotic bookantibiotic book. 2022. https:\/\/iris.who.int\/bitstream\/handle\/10665\/365135\/WHO-MHP-HPS-EML-2022.02-eng.pdf?sequence=1. Accessed December 6, 2023."},{"key":"S2732494X26104306_ref19","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.01860"},{"key":"S2732494X26104306_ref39","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1717295115"},{"key":"S2732494X26104306_ref12","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S290835"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X26104306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:59:05Z","timestamp":1781773145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X26104306\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S2732494X26104306"],"URL":"https:\/\/doi.org\/10.1017\/ash.2026.10430","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e181"}}