Megha Sharma

I am an Affiliated Researcher at the Department of  Global Public Health, Karolinska Institutet, Stockholm, Sweden in the research group, Health Systems and Policy (HSP): Medicines, focusing antibiotics and an Associate Professor at the Department of Pharmacology, R. D. Gardi Medical College, Ujjain, India.
Presently, I am the Coordinator of three multinational collaborative research projects titled:

1) “Antibiotic stewardship program including infection 
prevention and control and wastewater treatment – Implementation research in hospital and community in India (APRIAM)” between Sweden and India since 2017

2) 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)

3) "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.

I have worked as a Postdoctoral Fellow at the Division of International Health (IHCAR), Karolinska Institutet, in the HSP research group. In addition, I have coordinated and researched in three multinational, multidisciplinary collaborative research projects, acronym APRIAM I, II, III and IV” during 
2007-2010, 2010 -2013, 2013-2017, and 2018-20 respectively.

My main area of research is improving the judicious prescribing of antibiotics at healthcare facilities, rationalizing the use of antibiotics at
the community level, and minimizing antimicrobial resistance. I have collected baseline data of antibiotic prescribing for over 200, 000 in-patients from two tertiary care, private-sector hospitals from the private sector in Central India. I have established a strong system of manual data collection in the study hospitals, with the help of nursing staff.
Improving hygiene in healthcare facilities and the community is another research area of interest in order to combat antimicrobial resistance. I 
am the team leader for an interventional study that focuses on improving overall hygiene, focusing on hand hygiene and the introduction of
alcohol-based hand rub in healthcare facilities in Central India. The long-term aim of this study is to minimize healthcare-associated infections (HAIs)
and minimize the spread of infections, both at the healthcare facility and community level, which will lead to minimizing the overall use of antibiotics.
I have been regularly involved in teaching Master 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 for their Master's degree in Master of Global Health from the Department of Global Public Health, Karolinska Institutet, and basic medical education (läkarlinjen) students at Karolinska Institutet.
Presently, I am supervising 2 doctoral students, registered at Karolinska Institutet. I was the main supervisor of one OhD 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, and international journals. 

My work has been acknowledged and awarded at many International and National conferences.

The title of PhD thesis: Isolation & identification of active constituents of medicinal plants /Citrullus colocynthis /& /Artabotrys odoratissimus, awarded in 2001
MSc (Drugs and Pharmaceuticals)- Gold Medalist, 1997

Increasing bacterial resistance and an increase in incidences of healthcare-associated infections (HAIs) are topics of global concern. Lack of
knowledge, financial constraints and humid and moist climate of low-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. AA 
significant number of mortalities and morbidity, the  cost of treatment and the duration of hospital stay could be minimized by reducing the use of 
antibiotics, preventing the spread of HAIs and bacterial resistance.
A long-term study was designed and is being conducted at two tertiary care study hospitals in Central India since 2008. The main aim of the study was to provide a baseline of antibiotic prescribing patterns and trends in these settings. Based on the results of the pre-intervention phase (Baseline data) context-relevant diagnosis-specific prescribing guidelines were developed and implemented at high-risk departments. The impact of the interventions will be evaluated in terms of a) reduction in antibiotic prescribing and rationality in prescribing antibiotics concerning the diagnosis.
Another aspect of the spread of infections is to reduce the spread of hospital-associated infections (HAIs) and to decrease antimicrobial
resistance. These hospitals are private, tertiary care hospitals; one teaching (750 beds) and one non-teaching (350 beds). Both are located in the Ujjain district in Madhya Pradesh, India.

The study design includes three phases: pre-intervention (baseline), intervention and post-intervention. As part of the pre-intervention phase, a
continuous data collection of antibiotic prescribing in both hospitals has been conducted 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 samples. 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 suggest the need for relevant guidelines for rational antibiotic prescribing and to improve the HH practice in these settings.

The intervention package consists of feedback meetings, development and implementation of antibiotic prescribing guidelines, the introduction of
alcohol-based hand rub (ABHR) and training and educational meetings with the staff. 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 done to present antibiotic
prescribing patterns and HAI incidence data and will be discussed with the prescribers. This will be to develop the context-relevant 
prescribing guidelines with the consensus of the prescribers. Pocket-sized printed guidelines will be distributed to the prescribers and posted in the wards. The mobile technology will be used to send reminders both for improving HH practice and for compliance with the guidelines.
In the post-intervention phase, the data on antibiotic prescribing will be recorded continuously to analyse compliance with the local guidelines. HAI
incidence rates will be monitored continuously. The compliance with HH practice will be observed, documented and analysed at several points. Economic feasibility will be checked to introduce the ABHR to the rest of the wards in the setting.

I am teaching regularly and regularly contribute to various courses held at Karolinska Institutet, Stockholm, Sweden, and to the undergraduate medical students at R. D. Gardi Medical College, Ujjain, India.

I have supervised 40 students in total till the Spring semester of 2025. Of those, 15 were Medical students who completed their degree project in Medicine from Karolinska Institutet (basic medical education- läkarlinjen), under my supervision, and 20  were Master's students in Global/ Public Health. 

Nine medical students have received various grants to visit the Indian study site. I have co-supervised one Doctoral student who 
defended her thesis titled: ‘Antibiotic prescribing at hospitals in Central India with limited access to diagnostic methods - what can be improved ' in order to reduce unnecessary antibiotic use and the development of antibiotic resistance in 2020.

 
At present, I am supervising two doctoral students registered at Karolinska Institutet, Sweden. I was the main supervisor of one OhD student who defended her thesis on 19 May 2025 and co-supervised one PhD student (2020), both registered at Karolinska Institutet, Sweden.