Megha Sharma

I am a Docent (Associate Professor) and a researcher in the Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden (since 2025), and am affiliated with the Health Systems and Policy (HSP) research group, Medicines Research Group, focusing on antibiotics. I am also an Associate Professor in the Department of Pharmacology at R. D. Gardi Medical College, Ujjain, India. 

My research area includes rational use of medicines, antimicrobial resistance (AMR), antimicrobial stewardship, pharmacovigilance, medicine safety, infection prevention, and health systems research. My work spans quantitative, qualitative, and implementation research, focusing on optimizing medicine use, adverse drug reactions, strengthening the national and international programms for HIV and infectious diseases, and evaluating healthcare interventions in diverse settings. I have conducted research on public health outcomes, with a particular interest in translating evidence into policy and practice to improve healthcare quality.
I collected data on antibiotic prescribing for over 200, 000 inpatients from two tertiary care, private-sector hospitals in Central India over 10 years. I established a robust manual data-collection system in the study hospitals by training a team of nursing staff.
Improving hygiene in healthcare facilities and the community is another research interest aimed at combating antimicrobial resistance. I lead an interventional study focused on improving overall hygiene, particularly hand hygiene, and introducingalcohol-based hand rub in healthcare facilities in Central India. The long-term aim of this study is to minimize healthcare-associated infections (HAIs) and the spread of infections in healthcare facilities and communities, and to rationalise overall antibiotic use.

Another area of research is adverse drug reactions (ADRs) and pharmacovigilance (PV), which supports the rational use of medicines by generating evidence on medicine safety and supporting informed prescribing practices. ADRs are systematically reported by healthcare professionals and patients through PV systems available globally, enabling the detection, assessment, and prevention of medicine-related harms. This work aligns closely with antimicrobial stewardship and AMR, as the rational use of antimicrobials helps reduce both ADRs and the emergence of resistant pathogens, improving patient safety and public health outcomes.

Presently, I am the Coordinator of three multinational collaborative research projects titled:

1) Building equity in digital global health: the case of antimicrobial resistance in low- and lower-middle-income countries (EquityAMR) for R. D. Gardi Medical College, Ujjain (Norway, India, SriLanka and Sweden).

2) "Antibiotic resistance: Preventive measures and minimizing consequences in Community, Patients, and the Environment through risk assessment and targeted interventions in the context of India" between Sweden and India since 2022.

3) SMS based reminders for vaccinations since 2019

I have been a Postdoctoral Fellow at the Division of International Health (IHCAR), Karolinska Institutet, in the HSP research group. In addition, I have coordinated and researched three multinational, multidisciplinary collaborative research projects, with the acronyms APRIAM I, II, III, IV, and V during 
2007-2010, 2010-2013, 2013-2017, 2018-2020, and 2021-2023, respectively.

I regularly teach Master's- and doctoral-level students at Karolinska Institutet, Sweden. I actively participate in academic activities and supervise 4-year undergraduate medical students in India. I have supervised National and International students in the Master of Global Health degree in the Department of Global Public Health, Karolinska Institutet, as well as basic medical education (läkarlinjen) students at Karolinska Institutet.

I currently supervise three doctoral students registered in the Department of Global Public Health, Karolinska Institutet, Sweden. I was the main supervisor of one PhD student who defended her thesis on 19 May 2025 and co-supervised one PhD student (2020), both registered at Karolinska Institutet, Sweden. I have published several research articles in peer-reviewed, indexed, international journals. My work has been acknowledged and awarded at several International and National conferences.
My PhD thesis, titled "Isolation & identification of active constituents of medicinal plants Citrullus colocynthis and Artabotrys odoratissimus", was awarded in 2001. I completed my Master's degree (MSc in Drugs and Pharmaceuticals) with a Gold Medal in 1997.

Increasing bacterial resistance and the increasing incidence of healthcare-associated infections (HAIs) are global concerns. Lack of knowledge, financial constraints, and the humid and moist climate of low- and middle-income countries put them at higher risk of antibacterial (antibiotic) use, the spread of infectious diseases, including healthcare-associated infections (HAIs), and thereby the development of bacterial resistance. Reducing antibiotic use, preventing the spread of HAIs, and curbing bacterial resistance could minimize mortality and morbidity, treatment costs, and hospital stay duration.
A long-term study was designed and conducted at two tertiary care hospitals in Central India since 2008. The main aim was to establish a baseline of antibiotic prescribing patterns and trends in these settings. Based on the pre-intervention (baseline) results, the team developed and implemented context-relevant, diagnosis-specific prescribing guidelines in high-risk departments. The impact of the interventions will be evaluated in terms of a) reduced antibiotic prescribing and more rational prescribing aligned with the diagnosis.
Another goal is to reduce hospital-associated infections (HAIs) and decrease antimicrobial resistance (AMR). These hospitals are private, tertiary care hospitals: one teaching (750 beds) and one non-teaching (350 beds). Both are in Ujjain district, Madhya Pradesh, India.

The study design includes three phases: pre-intervention (baseline), intervention, and post-intervention. During the pre-intervention phase, the researchers have collected continuous data on antibiotic prescribing in both hospitals since April 2008. Monitoring of HAI incidence started in high-risk wards from August 2010. To date, over 90, 000 patients have been enrolled in the prescribing study, and 843 suspected HAIs have been collected. High antibiotic prescribing was observed in both hospitals with high rates of HAIs. A recently published qualitative study from our group has shown that several infrastructural constraints hinder hand hygiene (HH) practices in the setting. These results highlight the need for relevant guidelines for rational antibiotic prescribing and to improve HH practice in these settings.

The intervention package includes feedback meetings, development and implementation of antibiotic prescribing guidelines, introduction of alcohol-based hand rub (ABHR), and staff training and educational meetings. The intervention phase for HH started with the introduction of in-house prepared, cost-effective ABHR in high-risk wards (WHO formulation), along with educational meetings in August 2011. Awareness campaigns for HH have also been conducted for the staff. Further, repeated feedback meetings will be held to present antibiotic prescribing patterns and HAI incidence data, which will be discussed with the prescribers. This will help develop context-relevant prescribing guidelines with prescribers' consensus. Pocket-sized printed guidelines will be distributed to the prescribers and posted in the wards. Mobile technology will be used to send reminders to improve HH practice and ensure compliance with the guidelines.
In the post-intervention phase, antibiotic prescribing data will be recorded continuously to analyze compliance with local guidelines. HAI incidence rates will be monitored continuously. We observed, documented, and analyzed compliance with HH practices. We assessed the economic feasibility of introducing the ABHR across all wards in the study settings.

I regularly teach and contribute to courses at Karolinska Institutet, Stockholm; Uppsala University; and Gothenburg University, Sweden, as well as to undergraduate medical students at R. D. Gardi Medical College (RDGMC), Ujjain, India.

As of the Spring 2026 semester, I have supervised 42 students. This includes 16 medical students who completed their degree projects in Medicine (basic medical education – läkarlinjen) at Karolinska Institutet, Sweden, and R. D. Gardi Medical College, Ujjain, India; 24 Master’s students were from Global/Public Health at Karolinska Institutet, Sweden; the University of Potsdam, Berlin, Germany; and Gothenburg University, Sweden. All students have successfully completed their thesis projects under my guidance. Ten of the Swedish medical students received competitive grants to conduct research visits to the Indian study site.

I have co-supervised one Doctoral student who defended her thesis in 2020 titled: ‘Antibiotic prescribing at hospitals in Central India with limited access to diagnostic methods - what can be improved to reduce unnecessary antibiotic use and development of antibiotic resistance'. 

I was the main supervisor of one Doctoral student who defended her thesis on 19 May 2025, titled "Antibiotic Prescribing in Surgery and Orthopaedics: Evolving Practices, Perceptions, and Resistance in Central India, ".

 
Currently, I supervise three doctoral students registered at Karolinska Institutet in Sweden.