Initiatives

The Department of Health and Family Welfare has released a comprehensive Standard Operating Procedure (SOP) to promote antibiotic literacy among hospitals and local self-government institutions across the state. The initiative aims to make Kerala an antibiotic-literate state by coordinating efforts among the public, local bodies, hospitals, and health service providers through a One Health approach. These guidelines have been issued as part of the Antibiotic Literate Kerala project, under which the state earlier introduced the world’s first Antibiotic Literate Panchayat concept.

As part of the initiative, the Health Department has developed an innovative accreditation system based on key performance indicators to regulate antibiotic use in hospitals and the community. Special certifications will be awarded to Antibiotic Smart Hospitals, Antimicrobial Stewardship–Compliant Hospitals, and Antibiotic Literate Local Self-Government Institutions. Separate criteria have been prescribed, taking into account the infrastructure and services available at different levels of healthcare institutions.

Primary Health Centres are required to comply with ten criteria, while secondary and tertiary hospitals must meet twelve criteria. A key requirement is that the majority of antibiotics prescribed in outpatient departments should belong to the World Health Organisation’s Access category. The minimum mandated usage of Access-category antibiotics is 95 per cent at the primary level, 90 per cent at the secondary level, and 85 per cent at the tertiary level. The scheme also emphasises reducing overall antibiotic use over time and preventing the sale of antibiotics without a valid medical prescription.

An attractive colour-coding system has been introduced to assess and grade the performance of hospitals. Institutions that meet the criteria at the highest level will be awarded a light blue status. Based on their scores, institutions will also be categorised under dark blue, green, yellow, and pink grades. All institutions under the Health Department and the Medical Education Department are required to complete the colour-coding process within three months of the release of the guidelines. District and Block Antimicrobial Resistance (AMR) Committees will oversee the implementation of this system in private hospitals as well.

To ensure effective implementation, robust monitoring mechanisms have been established at the institutional, block, district, and state levels. Institutional committees may conduct colour-coding assessments on their own, except for the light blue category. Block and district-level committees will review institutional performance every six months. The Antibiotic Smart Hospital certification will be valid for two years. By integrating modern treatment practices with strong public participation, the project is expected to emerge as a global model in tackling antibiotic resistance.