India faces a dual challenge of poor access to antibiotics for some patients and inappropriate antibiotic use in other settings, both of which contribute to the growing burden of antimicrobial resistance. This article, published in JAC-Antimicrobial Resistance, explores how reserve antibiotics could be introduced responsibly in Indian healthcare settings through a stewardship-linked access pathway.
Developed through the ICARS-supported TANDEM-ABX project, the article proposes linking access to reserve antibiotics with demonstrated antimicrobial stewardship practices in healthcare facilities. The authors highlight the importance of early planning, targeted stewardship strategies, real-time monitoring of prescribing and resistance trends, and locally adaptable models that reflect India’s diverse health systems. The proposed approach could generate important real-world evidence for introducing reserve antibiotics responsibly in resource-constrained settings, with potential lessons for other low- and middle-income countries.
