Other specific DSP article suggested by Editorial Board
Global strategies to fight carbapenem-resistant Acinetobacter baumannii (CRAB) infections.
Authors: Makwana N, et al
Abstract
Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as a formidable healthcare-associated pathogen, particularly in intensive care units, where it causes severe infections associated with prolonged hospitalization, limited treatment options, and high mortality. This review provides an integrated analysis of the global epidemiology of CRAB, the molecular mechanisms driving carbapenem resistance, and the increasing clinical significance of antibiotic hetero-resistance, which contributes to diagnostic failure and poor therapeutic outcomes. We highlight advances in diagnostic technologies, including whole-genome sequencing, digital PCR, and CRISPR-based platforms, which enable rapid identification of resistance determinants and detection of hetero-resistant subpopulations that are frequently overlooked by conventional susceptibility testing. Current treatment strategies are critically evaluated, with emphasis on optimized antibiotic combinations and emerging agents such as sulbactam-durlobactam and cefiderocol, alongside alternative approaches including bacteriophage therapy, antimicrobial peptidomimetics, and immune-modulating adjuncts. In parallel, the review underscores the importance of infection prevention and control measures, antimicrobial stewardship programs, and coordinated global surveillance initiatives in limiting CRAB transmission in high-burden healthcare settings. Collectively, the evidence indicates that effective control of CRAB infections requires a multidisciplinary, multimodal strategy integrating accurate diagnostics, sustainable therapeutic interventions, and robust public health policies to mitigate the escalating global impact of this priority pathogen.
Other specific DSP article suggested by Editorial Board
Promoting antibiotic pharmacotherapy in community pharmacies in low- and middle-income countries: why and how?
DOI: 10.1093/ijpp/riag030
Authors: Saha SK, et al
Abstract
Background: Antimicrobial resistance (AMR) disproportionately affects low- and middle-income countries (LMICs), where community pharmacies frequently serve as the first point of care for common infections. Inappropriate antibiotic dispensing, limited stewardship integration, regulatory weaknesses and gaps in pharmacy education contribute to suboptimal antibiotic use.
Objectives: To highlight why and how antibiotic pharmacotherapy should be promoted and strengthened within community pharmacy settings in LMICs.
Discussion: Community pharmacists are uniquely positioned to optimise antibiotic selection, dosing and duration; however, their stewardship potential is constrained by insufficient training, limited access to locally adapted guidelines, and inadequate decision-support tools. Strengthening antibiotic pharmacotherapy requires targeted education and continuing professional development, integration of AMS competencies into pharmacy curricula, local adaptation of evidence-based resources (e.g. AWaRe-informed tools), and scalable “”train-the-trainer”” models. Global North-South collaborations and sustainable financing mechanisms are essential to support implementation and scale-up.
Conclusion: Empowering community pharmacists with the knowledge, skills, competencies, and resources required to deliver evidence based antibiotic pharmacotherapy should be recognised as a core policy priority for antimicrobial stewardship in LMICs. Embedding structured pharmacy-targeted pharmacotherapy guidance within national AMR action plans and WHO-aligned frameworks is critical to reducing inappropriate antibiotic use, strengthening health system resilience, and preserving antimicrobial effectiveness.
Other specific DSP article suggested by Editorial Board
A Multi-sectoral Institutional Action to Boost Integrated Antimicrobial Stewardship to Curtail Antimicrobial Resistance: A World Antimicrobial Resistance Awareness Week (WAAW) Initiative in North India.
Authors: Panda PK, et al
Abstract
During World Antimicrobial Resistance Awareness Week (WAAW) 2024, All India Institute of Medical Sciences (AIIMS) Rishikesh implemented a structured, multi-sectoral Institutional Action Plan (IAP) to transition from conventional awareness activities to an integrated antimicrobial stewardship approach. The initiative emphasized coordinated institutional action through education, advocacy, and practice-based interventions involving healthcare workers, hospital administration, and the community. The seven-day program included institutional capacity building, assessment and incentivization, and public and community outreach activities. Evaluation was conducted using predefined indicators assessing healthcare worker knowledge enhancement through pre- and post-intervention assessments, compliance with bedside antimicrobial stewardship practices via interactive audits, adoption of standardized prescribing tools, and community outreach through educational roleplays and talks. Targeted training was delivered to over 300 healthcare workers, including focused stewardship training for pharmacists. The program achieved institution-wide engagement involving more than 3,000 participants. Key antimicrobial stewardship policy documents were released during the inauguration, reflecting administrative commitment. Bedside stewardship activities audited and trained over 1,000 healthcare workers across more than 40 clinical areas, leading to the identification of a high-performing clinical unit as the institutional stewardship champion. Core stewardship practices were reinforced through an institutional pledge taken by over 2,000 healthcare workers, and individual stewardship champions were identified across professional categories. Structured workshops strengthened stewardship competencies among selected participants, while public outreach activities reached over 1,500 community members. Media engagement further amplified program visibility and messaging. The IAP implemented during WAAW 2024 demonstrated a feasible, scalable, and integrated institutional model for antimicrobial stewardship. By combining policy reinforcement, structured training, performance recognition, and community engagement, the initiative fostered measurable behavior change across institutional and public domains. This technical framework may be adapted by other tertiary-care institutions to strengthen antimicrobial stewardship implementation and sustain long-term efforts to contain Antimicrobial Resistance (AMR).
Other specific DSP article suggested by Editorial Board
Probiotic-based therapeutics for a One Health future: redefining antibiotic dependency to combat antimicrobial resistance.
Authors: Pattapulavar V, et al
Abstract
Antimicrobial resistance (AMR) has become a major One Health concern, affecting the interconnected microbial systems shared by humans, animals, and the environment. Decades of antibiotic-driven control have disturbed ecological stability and contributed to the expansion of the global resistome. This Perspective approaches AMR mitigation through an ecological restoration lens, outlining a three-part strategy that brings together probiotic therapeutics, microbiome-focused public awareness, and integrated surveillance. Probiotics are presented as biologically compatible tools that promote microbial stability through competitive niche occupation, immune support, and environmental biodegradation, thereby reducing selective pressures that favor resistance. In parallel, strengthening microbiome literacy can guide behavioral choices that support stewardship and reduce unnecessary antimicrobial use. The proposed One Health Microbiome Intelligence Framework (OH-MIF) adds a data-driven layer by linking genomic, clinical, agricultural, and environmental information through AI-enabled analytics. Together, these components form an adaptable system that shifts AMR management from reactive dependence on antibiotics toward a more resilient, coexistence-based approach. By aligning ecological interventions with education and policy intelligence, this Perspective positions microbial balance as a practical foundation for sustainable AMR control within broader planetary health goals.