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overview (advance module)

Key Objectives of the Course

  • Deliver up-to-date, evidence- based, high-quality education on Antimicrobial Stewardship (AMS) and Infection Prevention & Control (IPC) practices.
  • Share evidence about the various AMS and IPC strategies, practicalities of implementing these interventions in a healthcare setting in a low – and middle- income country and how their outcomes can be measured and presented.
  • Provide training on non-clinical aspects of AMS and IPC which will enable to improve the design anf delivery of the intervention.

Course Duration : Three month from the day of access provision

Target Audience

  • Healthcare professionals from tertiary care hospitals.
  • Clinical Pharmacists
  • Academicians
  • Students
  • Individuals who have successfully completed the Basic Module with a passing grade in all assignments

Course Fee : INR 3500

program overview

Course Highlights
  • Experienced faculty from both national and international perspectives
  • Hands-on-Training for 1 week at Amrita Hospital, Faridabad.
Why join this course and what to expect?
  • Expert Guidance
  • Comprehensive Learning
  • Pratical Focus via Hands-on-training
Mode of Delivery
  • Self-paced online classes along with an optional one-week training at Amrita Hospital, Faridabad.
Course Content
  • Diagnostic Stewardship
  • Antimicrobial Stewardship (including Anti-fungal and Anti- TB stewardship programs)
  • Advanced IPC
  • Clinical Pharmacy: PK-PD and Therapeutic Drug Monitoring
  • Application of CDSS and AI in AMSP

Team

Appropriate selection of antibiotics based on phenotypic and molecular diagnostics

Dr. Sumit Rai

Professor and Head, Dept. of Clinical Microbiology & Infectious Diseases, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh

Anti-Fungal Stewardship


Dr. Aruna Poojary

Laboratory Director, Incharge – IPC, Dept. of Pathology & Mirobiology, Breach Candy Hospital, Mumbai

Preparation of antibiogram and antibiotic policy


Dr. Anita Sharma

Director, Department of Lab Medicine, Fortis Hospital, Mohali

Diganostic Stewardship



Dr. Sharmila Sengupta

Associate Professor, Dept. of Microbiology, Amrita School of Medicine, Faridabad.

Pharmacokinetic – Pharmacodynamic Considerations for Optimized Dosing of Antimicrobials

Dr. Avaneesh Kumar Pandey

Senior Researcher, CAMO – Net (India Hub), PGIMER, Chandigarh

Pharmacokinetic – Pharmacodynamic Considerations for Optimized Dosing of Antimicrobials

Dr. Rikita Kondel Bhanderi

Post Doctoral Researcher, CAMO – Net (India Hub) PGIMER, Chandigrah

Pharmacokinetics – Pharmacodynamics, Consideration for Optimized Dosing of Anrimicrobials

Dr. Nusrat Shafiq

Clinical Pharmacology unit, Dept. of Pharmacology, PGIMER, Chandigrah

Comprehensive Strategic Approach to Antimicrobial Stewardship


Dr. Twisha Patel

PharmD, BCIDP, Public Health, USA

Comprehensive Strategic Approach to Antimicrobial Stewardship


Dr. Payal Patel

Infectious Disease Physician, Associate Professor, Medical Director of Antimicrobial Stewardship, Intermountain Health, USA

Antimicobial Stewardship in Special Settings – Based on Case Scenarios

Dr. Anup Warrier

Consultant, Department of Infectious Diesease & Hospital Infection Control, Aster Medicity Hospital, Kochi.

Anti–tubercular Stewardship (Interview)


Dr. Camilla Rodrigues

Consultant Microbiologist, Chair person Infection Control committee, Head of Department of Lab Medicine, P. D. Hinduja Hospital & Medical research Center

Clinical Decision Support System for Antimicrobial Prescribing

Dr. Nathan Peiffer Smadja

Associate Professor, Dept. of Infectious Disease & Tropical Medicine, Bichat Claude Bernard Hospital, Ap-HP

Role of Patients and the Public in Antimicrobial Stewardship and Infection Prevention Control


Dr. Oluchi Mbamalu

Senior Lecturer, University of Cape Town

Role of Social Science in Antimicrobial Stewardship and infection Prevention and Control (Discussion)

Dr. Candice Bonaconsa

Research Officer, University of Cape Town

Role of Social Science in Antimicrobial Stewardship and Infection Prevention and Control (Discussion)

Dr. Vrinda Nampoothiri

Post Doctoral researcher, Amrita Institute of Medical Sciences and Research Center, India

Role of Social Sciences in Antimicrobial Stewardship and Infection Prevention and Control (Discussion)

Dr. Esmita Charani

Associate Professor, University of Cape Town

Implemention Science



Dr. Raheelah Ahmed

Associate Professor, St. Georges, University of london

Advanced Infesction Prevention and Control : Implementation of improvement Science


Dr. Daniel Vanderendale

Medical Officer, DC

Economic evaluation in infection prevention and control and antimicrobial stewardship

Dr. Nina Zhu

Research Fellow, Centre for Antimicrobial Optimisation, Imperial College, London

How to create and present a data dashboard


Dr. Bernard Hemandez

Post Doctoral Research Fellow, Imperial College, London

Health Economis and AMR


Dr. Elly Nuwamanya

Research Health Economist, IDI, Uganda

The One Health Approach

Prof. Anna S. Levin

Professor, University of Sao Paulo. Brazil

Dr. Ashutosh Sharma

Medical Superintendent, Amrita Hospital, Faridabad

Dr-Prem-Kumar-Nair_Dean-Medical-Director--Professor_Gastroenterology_medicine_amritauniversity_kochi2

Dr. Prem Nair

Group Medical Director, Amrita Hospitals

Swami Nijamritananda Puri

Administrative Director, Amrita Hospital, Faridabad

Dr. Sanjeev K. Singh

Medical Director, Amrita Institute of Medical Sciences, Faridabad, Haryana

Course Director

Dr. Sathyanarayana Reddy B.

Clinical Pharmacist, Amrita Institute of Medical Sciences, Faridabad, Haryana, India

Cheif Course Co-Ordinator

Dr. Vrinda Nampoothiri

Post Doctoral Researcher, Amrita Institute of Medical Science Faridabad, Haryana, India

Dr. Kusum Rani

Post Dotoral Researcher

Amrita Institute of Medical Sciences Faridabad, Haryana, India

Dr. Arya S. Kumar

Project Scientist – III

Amrita Institute of Medical Sciences Kochi, Kerala, India

Ms. Fabia Edathadathil

Quantitative Researcher

Amrita Institute of Medical Sciences Kochi, Kerala, India

Dr. Meera Susan John

Clinical Pharmacist

Amrita Institute of Medical Sciences Kochi, Kerala, India

Dr. Sherya H

Clinical Pharmacist

Amrita Institute of Medical Sciences Kochi, Kerala, India

Dr. Aleena Issac

Senior Research Fellow

Amrita Institute of Medical Sciences Faridabad, Haryana, India

program overview

Evaluation

Basic Course:

  • Participants will take a quiz at the end of each module.

Advanced Course:

  • Participants will take a quiz at the end of each module.
  • A short project must be completed in their institution, applying the principles discussed in the course.
Course Outcomes

Basic Course:
Participants will:

  • Gain high-quality education on AMS and IPC practices.
  • Learn about various AMS and IPC strategies and how to implement them in healthcare settings.
  • Understand the practicalities of applying these interventions in low- and middle-income countries and how to measure and present the outcomes.

Advanced Course:
Participants will:

  • Expand their scope of AMS and IPC interventions in their healthcare setting.
  • Receive training on non-clinical aspects of AMS and IPC, improving the design and delivery of these interventions in their institutions.
Course Overview
25AMIP101A Antimicrobial Stewardship and Infection Prevention and Control-Basic CourseP/F
Topic Speakers
Introduction to the course Alison Holmes, Professor in Infectious Diseases, Imperial College London, UK
Basics of Microbiology Dr. Meher Rizvi,Associate Professor, Department of Microbiology and Immunology, Sultan Qaboos University, Oman
Interpretation of Laboratory data Dr. Anilkumar, Professor, Department of Microbiology, Amrita Hospital, Kochi, Kerala
Introduction to Pharmacology ( Part I) Kinetics

  1. Systematic approach in selection of antibiotic regimen
  2. MIC and MBC
  3. ABTIBIOTICS CLASSIFICATION
 Dr. Grace Mary John, Infectious Diseases Clinical Specialist and Chief Clinical Pharmacist at Believers Church Medical College Hospital , Thiruvalla, Kerala
Introduction to Pharmacology ( Part II) Dynamics

  1. Basic pharmacodynamic concepts with clinical correlation
  2. Drug Receptors – Brief overview · Drug Potency and Efficacy
  3. Dose Response Relationship
  4. Concentration Dependent / Time Dependent Antibiotics
  5. Plasma Concentration to drug effect at receptor sites
  6. Factors considered in drug dosing
  7. Factors modifying drug action
  8. Therapeutic drug monitoring
 Dr. Subrajyoti Bhowmik,Associate Professor of Pharmacology at KPC Medical College, Kolkata
Introduction to AMR( causes and spread -one health concept & burden)

  1. Human microbiome, definition of AMR/ABR
  2. Mechanisms of AMR Causes and spread of AMR
  3. One health concept Burden of AMR – global, India
  4. Healthcare, economic aspects; future scenario
 Dr. Kiranjeet Kaur,Assistant Professor, Chitkara University, Patiala
How to develop and implement a one health approach to AMR Prof. Karin Thursky Director of the National Centre for Antimicrobial Stewardship (NCAS), Australia
Strategies to prevent and control (policies, GAP, NAP)

  1. Objectives
  2. Interventions
  3. Output Policies National Policy on AMR Containment
  4. National programme on antimicrobial stewardship programme of infection and control (ASPIC) by ICMR
  5. Schedule H1 category
  6. Redline medical campaign
  7. Draft standards of antibiotic reduce in pharmaceutical industrial effluent and common effluent treatment plans developed by central pollution control board
  8. 3 DECLARATIONS – Jaipur, Chennai, Delhi Declarations
 Dr. Marc Mendelson, Professor, Department of Infectious Diseases, University of Cape Town, South Africa
Introduction to AMSP Dr. Zubair Umer Mohammed, Associate Professor, Anesthesiology and Critical Care, Amrita Hospital, Kochi, Kerala
Principles of AMSP with examples Dr. Priscilla Rupali, Sr. Professor & Head of the Department of Infectious Diseases at Christian Medical College Vellore
Importance of multidisciplinary AMS team and how to create a team based on available resources Dr. Kamini Walia, Senior Scientist, Indian Council of Medical Research &DrPayal Patel,Systemwide Medical Director of Antimicrobial Stewardship at Intermountain Health, USA
AMS strategies

  • How to evaluate the inappropriateness in antimicrobial prescription and select strategies accordingly, for e.g., use of PPS
  • The importance of implementing an AMS strategy based on the available resources
  • Introduction to various AMS strategies in brief
  • Back end strategy- prospective audit and feedback with examples
  • Supplemental strategies- e.g TDM (removed— already covered in intro to pharmacology)
  • How to select low hanging fruits AMS strategy in resource limited settings
 Dr. Mohammed Hisham, Lead Clinical Pharmacist at Cleveland Clinic Abu Dhabi
Common clinical indication – 2 focus (session I) – URTI & LRTI , Sepsis Dr. Ram Subrahmaniam, Infectious Disease specialist, Apollo Hospitals Chennai, Tamil Nadu
Common clinical indication – 2 focus (Session II) – Intra abdominal , CNS, Bacteremia Carlos Palos,physician in Intensive Medicine and Internal Medicine and coordinator of the group of infection control and resistance to antimicrobials of Luz Saúde and Hospital Beatriz Ângelo, Portugal
Common clinical indication – 2 focus (Session III) – Skin and Soft tissue, Bone and Joint infections DrSubrahmaniamSwaminathan, Director of Infectious Diseases at the Gleneagles Global Hospita, Chennai, Tamil Nadu
Common clinical indication – 2 focus (Session IV) – Urinary tract infections, Infective Endocarditis DrTanusinghal,Consultant, Paediatrics and Infectious Disease, KokilabenDhirubhaiAmbani Hospital, Mumbai, Maharashtra, India
Surgical prophylaxis

  1. Selection of agent (characteristics, efficacy, safety, allergies etc)
  2. Time of administration
  3. Duration
  4. How to do surveillance of HAI and reporting
 DrPuneetDhar, Head, Gastrointestinal Surgery, Amrita Hospital, Faridabad, Haryana
How to do surveillance of HAI and reporting

  1. Understand the purpose of surveillance for healthcare-
  2. Associated infections (HAIs)
  3. Describe key terms and case definitions used in HAI
  4. Surveillance
  5. Complete bloodstream infection (BSI) and urinary tract
  6. Infection (UTI), Ventilator Associated Pneumonia
  7. (VAP) and Surgical site Infection
  8. Case report forms and denominator forms
  9. Conduct basic analysis of HAI surveillance data
 DrPurvaMathur, Professor, All India Institute of Medical Sciences, New Delhi
Standard precautions

  1. Definition
  2. Hand hygiene
  3. PPE
  4. Respiratory Hygiene & Cough etiquette
  5. Safe injection practices
  6. Disinfection &sterilisation of medical equipment
  7. Biomedical waste management
  8. Handling of blood & body fluids
 Dr Arya S Kumar, Project Scientist, Amrita Hospital, Kochi, Kerala
Transmission based precautions, outbreak management

  1. Airborne precaution
  2. Contact
  3. Droplet outbreak management in hospital setting
 DrPoornima B, Assistant Professor at the Department of Microbiology, Amrita Hosptial, Kochi, Kerala
Data reporting and analytics (AMSP and IPC) Types of metrices Surveillance metrices-structural, process, consumption AMR metrices- regulatory requirements Ms Fabia ET, Quantitative Researcher, Amrita Hospital, Kochi, Kerala
25AMIP111A Antimicrobial Stewardship and Infection Prevention and Control-Advance course P/F
Introduction to advanced MOOC Alison Holmes, Professor in Infectious Diseases, Imperial College London, UK
Preparation of antibiogram and antibiotic policy

  1. What is a Hospital antibiogram (cumulative antibiogram) Definition, Why is it required?, Who is likely to use it?
  2. How to prepare Hospital antibiogram/CA
  3. Enhanced CA
  4. Interpreting & presenting antibiogram
  5. Hospital & department specific antibiotic policy
 Dr. Anita Sharma, Fortis Mohali
Diagnostic Stewardship

  • Definition
  • Objectives of microbiological diagnostic stewardship
    • Discuss the role of the diagnostic microbiology in ASP
    • Develop antibiotic susceptibility reporting format which should be consistent with CLSI/EUCAST recommendations (Section 2)
    • Identifying and incorporating promising developments in diagnostic testing
    • Deciding on how and what should be incorporated into ASP efforts
    • Diagnostic stewardship(DSP), Infection prevention & control(IPC) and Antimicrobial stewardship (ASP) – DIA
 Dr. Sharmila Sengupta, Senior Consultant, Department of Microbiology, Amrita Hospital, Faridabad
Appropriate selection of antibiotics based on phenotypic and molecular diagnostics Dr. Balaji, Professor, Department of Clinical Microbiology, CMC Vellor
PK/PD

  • List different PK/PD parameters associated with efficacy for various antimicrobial classes
  • Describe how it is determined if an organism is “susceptible” at various minimum inhibitory concentration (MIC) values
  • Discuss how different PK/PD parameters for efficacy mandate different dosing strategies for different antimicrobial classes
  • Describe strategies for implementing PK/PD into antimicrobial stewardship programs and the impact it can have on outcomes
 Nusrat Shafiq, Professor, Department of Pharmacology at the Postgraduate Institute of Medical Education and Research, Chandigarh, India
Comprehensive strategic approach to ASP

  • Developing multidisciplinary team
  • Identifying priority area for intervention
  • Implementing AMS activities
 Dr. Twisha Patel, CDC, USA &DrPayal Patel, System wide Medical Director of Antimicrobial Stewardship at Intermountain Health, USA
AMS in special setting – based on case scenarios

  • Oncology and hematology
  • Liver and Kidney transplantation
  • Sepsis
  • Fungal infections Pediatric/neonatal Emergency setting
 Dr. AnupWarrier, Senior Consultant – Infectious Diseases, Aster Medcity, Kochi, Kerala
Antifungal Stewardship

  • Introduction
  • Overview on emerging antifungal resistance
  • Economic and health impacts of invasive fungal infections
  • Antifungal stewardship Principles and Core elements
  • Antifungal Stewardship interventions with examples
  • Antifungal Stewardship in immunocompromised patients Fungal diagnostic testing (culture and non-culture based tests)
  • Use of metrics in Antifungal Stewardship (Process and outcome),
  • Conclusion
 Arunaloke Chakrabarti
Professor, Postgraduate Institute of Medical Education and Research, Chandigarh
Antitubercular Stewardship Dr. Camilla Rodrigues, Senior consultant microbiologist and the Chair of the Infection Control Committee, P.D. Hinduja Hospital, Mumbai, Maharashtra
Application of IT in ASP E.g Role of CDSS in ASP

  • Role of CDSS
  • Types
  • Applications and use
 Dr. Nathan PeifferSmadja, Honorary Clinical Research Fellow
Department of Infectious Disease, Imperial College London, UK
Role of patient and public in ASP and IPC

  • What role do patients and public play?
  • Mechanisms by which patient/public role can be improved in IPC and antimicrobial decision making
  • How do we inculcate their role into policies and guidelines
 Dr. Oluch iMbamalu, Senior Lecturer in the Global Surgery Division, University of Cape Town, South Africa
Understanding of site context and the role of social science in AMS and IPC

  1. Understandings from Social Science perspective- Hierarchy, the type of patients the hospital caters to, engagement from hospital administration with example of findings from social science study
  2. Different methods used in social science
    • Observations
    • Ward round observations
      • Focused observations
      • Case studies
      • Sociograms
      • Interviews and focus group discussions
  3. Qualitative Data analysis
  4. Ethics, data triangulation, and reflexivity in qualitative studies
 Dr. EsmitaCharani, Associate Professor, University of Cape Town, South Africa; Ms Candice Bonaconsa, Nurse Researcher and PhD candidate, University of Cape Town, South Africa
Implementation science

  • Principles
  • Application
  • Defining metrices/outputs
 Dr. Raheelah Ahmed, Reader, University of London, UK
Advanced IPC – Implementation of improvement science Dr. Daniel Vanderende, Medical Officer at CDC, USA
how to incorporate AMS and IPC to hospital costing models Nina Zhu, Research Lead for Population Health and Policy, Imperial College London, UK
How to create a present a data dashboard Bernard Hernandez, post-doctoral research associate at the Centre for Bio-Inspired Technology at Imperial College London.
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