Welcome Note: Dr. Shubhi Kulshrestha (PT) from Medical Learning Hub welcomed the esteemed speaker, Dr. Haritha Madigubba along with the participants.
Session: From Lab Bench to Bedside: Demystifying MICs, Breakpoints & the Art of Stewardship by Dr Haritha Madigubba, Consultant Microbiologist and Infection Control Officer at Sindhu Hospitals, Hyderabad - Key Points covered in the session were:
- Definition: Medicines targeting bacterial infections by inhibiting growth or killing bacteria.
- Limitations: Ineffective against viral infections (e.g., cold, flu).
- Historical Impact: Penicillin’s discovery (1928) revolutionized medicine.
- Causes: Overuse in humans/livestock, incomplete treatments, poor infection control, lack of new antibiotics.
- Consequences: Increased treatment failures, higher mortality, and economic burden.
- AMR Trends in India (2010–2023): Rising resistance in pathogens like MRSA (29%→47%), Klebsiella (29%→67%), and Acinetobacter (50%→70% to meropenem).
Antimicrobial Stewardship (AMS) :
- Goal: Ensure the right antibiotic, dose, route, and duration for patients while minimizing resistance.
- CDC Framework: Emphasizes evidence-based prescribing and multidisciplinary collaboration.
- Administrative Support: Leadership commitment and funding.
- Assess Infrastructure: Diagnostic labs (e.g., MALDI-TOF, rapid tests), IT systems (LIS/HIS), and manpower (ID physicians, pharmacists).
- Form AMS Team: Microbiologists, clinicians, pharmacists, nurses.
- Develop Antibiotic Policy: Local antibiogram-based, consensus-driven handbook.
- Implement Strategies: 1. Front-end: Formulary restrictions (e.g., carbapenems require approval). 2. Back-end: Prospective audits, de-escalation based on AST reports.
- Education: Training on guidelines, cascade reporting, and intrinsic resistance.
- Cascade Reporting: Prioritize narrow-spectrum antibiotics if effective.
- MIC & Breakpoints: Interpret susceptibility using CLSI categories (S/I/R/SDD).
- Therapeutic Index (TI): Higher TI indicates better efficacy (e.g., meropenem TI=4).
- MRSA vs. MSSA: MSSA responds better to beta-lactams; MRSA requires alternatives.
- Low-Hanging Fruits: Easy wins like IV-to-oral switches, avoiding redundant antibiotics.
- WHO Advocacy: Address AMR through policies like "Start Smart, Then Focus" (UK).
- Collaboration: Multidisciplinary teamwork and open communication are critical.
Q&A Session: Participants actively engaged in a Q&A session moderated by Dr.Shubhi, where Dr. Haritha Madigubba, addressed queries and shared expert insights.
Closing Remarks: Dr. Shubhi Kulshrestha concluded the session with a vote of thanks, appreciating the speaker and participants for their valuable contributions.
We wish you a great learning experience!
Theme Topic: From Lab Bench to Bedside: Demystifying MICs, Breakpoints & the Art of Stewardship.
- Session : From Lab Bench to Bedside: Demystifying MICs, Breakpoints & the Art of Stewardship.- Dr Haritha Madigubba, Consultant Microbiologist and Infection Control Officer at Sindhu Hospitals, Hyderabad (20 Min)
- Q&A Session: (10 min)
- Vote of Thanks : (5 mins)
- Consultant
- Family medicine
- Pediatricians
- ENTs
- GPs
- ID specialist
