Antibiotic resistance: Preventive measures and minimizing consequences through risk mitigation and targeted interventions in the context of India

(APRIAM Project)

Antibiotics are a prerequisite for many of today’s present and emerging healthcare technologies and a functioning health system. The WHO in 2012, declared ‘Antibiotic resistance’ as ‘A global health crisis that has been building up over decades. System-wide collaborative actions in the fields of rational use of antibiotics, infection prevention and control and sectors outside human medicine are called for. Access to effective antibiotics is a highly prioritized area, especially for low- and middle-income countries where the infectious disease burden is high Estimates indicate significant increasing mortality, morbidity and health care costs due to resistance. If proper methods and technologies are not developed for efficient antibiotic use and containment of resistance, healthcare will be severely affected. Realizing this and that antibiotic resistance respects no borders - geographical or legal - the WHO classifies resistance as a threat to global public health and the development of technologies for containment of resistance as a global public good. The three most important ways to minimize resistance development and spread are; (i) rational use of antibiotics, (ii) monitoring and control of infections including HAIs and maintaining good hygienic standards so that bacteria, whether resistant or not, do not spread and (iii) avoiding contaminating the environment with antibiotics.

 APRIAM project is a that is a collaborative research project with Karolinska Institutet, Sweden continuing since 2007. The overall aim of the project is to understand the situation of Antibiotic prescribing and resistance among humans, animals and the environment as per the ‘One Health’ model and to establish solutions to tackle Antibiotic Resistance. The general aim of the project is to progress from the development and evaluation of short-term interventions to long-term implementation and evaluation of comprehensive context-relevant interventions based on results and experiences from the previous phase. We aim to implement an “Antibiotic Stewardship” program to promote rational antibiotic use and surveillance of resistance; an “Infection prevention and control” program to develop better resistance management systems and prevention of infections including HAI; and a “Waste management” program focusing on the treatment of wastewater in health care settings.

The long-term aim of the project is, to present feasible intervention models for improved management of bacterial resistance to antibiotics, based on knowledge about barriers and facilitators for implementation, associations between prevention, antibiotic use, antibiotics in the environment and various molecular types of antibiotic-resistant tracer bacteria with the ultimate aim to maintain the possibility to use antibiotics when indicated.

Innovative Hand Hygiene Activities conducted under APRIAM Project at RDGMC, Ujjain By Dr. Megha Sharma and her team