GUARDIAN — Governance and Utilization of Antimicrobials through Rational Drug-Integration, Advocacy, and Nurturing: A pharmacologist’s 20-point action
Authors: Rachna Rohilla, Sumit Rai, Prasan Kumar Panda
Keywords: Antimicrobial Stewardship, Pharmacologist , GUARDIAN, Stewardship
Abstract:
Antimicrobial resistance (AMR) remains a persistent and complex threat to healthcare delivery in India. While clinicians are primarily responsible for antimicrobial prescriptions, pharmacologists possess the unique capacity to influence and optimize their rational use through evidence-based guidance, pharmacologic expertise, and structured stewardship participation. The Integrated Antimicrobial Stewardship (IAS) framework encourages every institution to institutionalize rational antimicrobial practices through pharmacologists’ active engagement in governance, education, therapeutic monitoring, and accountability systems. This advocative editorial highlights 20 actionable practice points across antimicrobial, diagnostic-preventive, and administrative domains, where pharmacologists can meaningfully contribute to national AMR containment efforts. As stewards of pharmacologic reasoning, they bridge the gap between prescriber intent and therapeutic precision, ensuring that every dose, duration, and drug choice aligns with patient safety and stewardship principles. Through this multifaceted role, pharmacologists embody the concept of GUARDIAN — Governance and Utilization of Antimicrobials through Rational Drug-Integration, Advocacy, and Nurturing — safeguarding antimicrobial efficacy for present and future generations based on 42 consensus practice statements by the Society of Antimicrobial Stewardship PractIces (SASPI) in India.
