Note on Specialty Availability
The Infectious Diseases Department is a highly specialized service that is not available in all hospitals.
Across India, the specialty of Infectious Diseases remains rare, with a significant deficit of trained specialists.
In Kerala specifically, there are only a handful of Infectious Diseases physicians available, concentrated primarily
in select tertiary care and multispecialty hospitals [web:132][web:144] [web:147]. This scarcity underscores the
critical importance of ID departments in hospitals where they are available.
The Infectious Diseases Department serves as a critical resource for all hospital departments, providing expert
consultation on infection diagnosis, management, and prevention. From routine infections to multidrug-resistant
organisms and complex antimicrobial challenges, ID specialists work collaboratively with primary teams to optimize
patient outcomes and reduce healthcare-associated infections hospital-wide. Through leadership in antimicrobial
stewardship and infection prevention, the department enhances the quality and safety of care delivered across the
institution.
How Infections Affect Your Body
Infection begins when bacteria, viruses, or germs enter and multiply. The immune system reacts—temperature rises,
muscles ache, appetite drops. Viral infections often settle with rest and fluids. Bacterial infections require
antibiotics. The challenge is early identification and correct treatment.
Common Infections and Recognition
Respiratory infections cause fever, cough, and sore throat. Gastrointestinal infections produce vomiting or loose
motions. Urinary or skin infections create localized pain or swelling. Most respond well when addressed early, but
ignored or partially treated infections become serious.
When to Consult the Infectious Diseases Department
Not all fevers require immediate Infectious Diseases Department consultation. Most common infections are managed
effectively by primary care and ward teams with supportive care. However, when infections appear complex, unusual,
resistant to initial treatment, or when multidrug-resistant organisms are suspected or confirmed, the primary team—
whether surgery, medicine, critical care, or other departments—will call upon the Infectious Diseases Department for
expert opinion and guidance.
ID specialists bring diagnostic expertise, antimicrobial knowledge, and infection prevention insights that help
primary teams optimize treatment, improve outcomes, reduce length of stay, and lower healthcare costs across the
entire hospital. When the primary team recognizes the need for ID consultation—ideally within the first 2 days of
suspecting a complex infection—it delivers the greatest benefit to the patient and hospital system [web:128].
The Proven Value of Infectious Diseases Consultation
Evidence from large-scale healthcare data demonstrates the substantial value ID physicians provide to hospital
systems. Studies of Medicare claims involving over 272,000 patient stays show that early ID physician intervention
(within 2 days of hospital admission) results in shorter lengths of stay, reduced 30-day mortality rates
(8.6% vs 9.6%, p<.001), lower 30-day readmission rates (24.6% vs 26.1%, p<.001), and significantly lower total
healthcare costs over 30 days ($8,739 vs $9,318, p<.001) [web:128].
Similarly, analysis of privately insured patients reveals that early ID physician involvement shortens hospital
stays, reduces costs, lowers mortality, and decreases the likelihood of readmission. These findings demonstrate
that ID physicians are uniquely positioned to positively impact the “Triple Aim” of healthcare—better health,
better care, and lower per capita cost—across all hospital departments.
Beyond direct patient care, ID physicians provide essential value through curbside consultations and informal
guidance that represent substantial clinical work (approximately 17% of an academic ID unit's total work value)
and extend into infection prevention, stewardship activities, and health system efficiencies [web:128].
The Specialist Consultation
The visit begins with detailed discussion about symptom onset, progression, and contextual factors (recent travel,
food, water source, sick contacts). This guides diagnosis before tests. Physical examination assesses temperature,
breathing, pulse, and affected areas to understand how infection affects the whole body.
Tests, when needed, are simple and purposeful—blood tests show immune response and infection type; swabs or imaging
confirm location and extent.
Treatment and Recovery
Once treatment begins, improvement happens gradually. Fever reduces first, appetite improves, strength returns in
stages. Completing full antibiotic courses is critical—stopping early allows infection recurrence.
Recovery time varies; tiredness can linger even after fever settles. Certain infections take longer in older adults
or those with diabetes, lung disease, or weakened immunity.
Managing Multidrug-Resistant Organisms (MDROs)
Multidrug-resistant organisms (resistant to three or more antibiotic classes) are increasingly common and
complicate treatment significantly. Key resistant pathogens include methicillin-resistant Staphylococcus aureus
(MRSA), vancomycin-resistant enterococci, and carbapenem-resistant gram-negative bacteria [web:102] [web:104].
When primary teams—surgery, medicine, critical care, or other departments—encounter patients with suspected or
confirmed MDRO infections, they call upon the Infectious Diseases Department for expert guidance. ID specialists
play a central role in MDRO management through identification and surveillance of resistant pathogens, targeted
antimicrobial therapy based on susceptibility testing, and development of institution-specific treatment protocols.
This multidisciplinary consultation model allows primary teams to focus on their core responsibilities while
leveraging ID expertise to optimize antimicrobial selection and prevent transmission [web:102] [web:104] [web:123].
Deep-Seated Infections Requiring Complex Management
Some infections involve prosthetic implants, bone, heart valves, or central nervous system structures. These
deep-seated infections are difficult to treat due to biofilm formation (protective bacterial communities resistant
to antibiotics) and antimicrobial-resistant organisms.
The Infectious Diseases Department collaborates with surgical specialists, utilizing advanced diagnostics and
prolonged antimicrobial therapy, to optimize outcomes in these challenging cases.
Antimicrobial Stewardship: Optimizing Care Across the Hospital
Antimicrobial stewardship (AMS) is the ID Department's cornerstone strategy for optimizing antibiotic use,
improving patient outcomes, reducing resistance, and lowering costs hospital-wide
[web:110][web:112][web:114][web:116].
Core AMS elements include physician leadership, rapid diagnostic support, prescribing guidelines, audit and
feedback mechanisms, and workforce education. ID physicians coordinate AMS committees, develop institution-specific
treatment protocols, provide expert consultation to all departments, and monitor resistance trends using
antibiograms and surveillance data.
Physician-led AMS programs deliver measurable benefits: reduced unnecessary antibiotic use, shorter patient
hospital stays, lower mortality rates, decreased readmissions, and reduced healthcare-associated infections across
all hospital departments [web:128].
Hospital-Wide Infection Prevention and Control
The Infectious Diseases Department leads hospital-wide infection prevention and control initiatives that benefit
all departments. Prevention begins with understanding how infections spread and implementing standard precautions,
contact precautions, and environmental hygiene measures.
For MDRO control, ID specialists develop surveillance protocols, coordinate outbreak investigations, and provide
ongoing education to clinical and non-clinical staff [web:104] [web:126]. These coordinated efforts reduce
healthcare-associated infections, improve patient safety, and lower treatment costs across the institution.
Daily Life and Recovery
Rest supports healing; light movement aids circulation. Fluids and simple food aid recovery. Work can resume once
fever settles and strength improves. Your doctor guides timing based on recovery progress.
Conclusion
The Infectious Diseases Department is an essential institutional resource providing multidisciplinary consultation,
diagnostic expertise, and antimicrobial guidance to all hospital departments. Primary teams—surgery, medicine,
critical care, and others—routinely consult ID specialists when encountering complex infections,
multidrug-resistant organisms, or antimicrobial challenges.
Through expert diagnosis, targeted therapy, antimicrobial stewardship leadership, and hospital-wide infection
prevention, the ID Department improves patient outcomes, reduces healthcare costs, decreases length of stay,
lowers mortality, and prevents readmissions across the entire institution.
Evidence-based data from large healthcare claims studies conclusively demonstrate that early ID consultation—
within the first 2 days of hospital admission—delivers measurable benefits including reduced mortality, shorter
hospital stays, lower readmission rates, and significant cost savings.
Given the proven value and unique expertise of ID physicians, hospital administrators and clinical leadership
should prioritize early ID consultation for complex infections and establish mechanisms to facilitate rapid access
to ID specialist expertise for all departments. Early consultation with the Infectious Diseases Department ensures
optimal care for patients and measurable benefits for the hospital system.
Frequently Asked Questions
What are infectious diseases?
Infectious diseases are illnesses caused by bacteria, viruses, or other germs. They spread through air, food,
water, insects, or direct contact with infected persons.
When should I see an infectious disease specialist?
Consult a specialist if fever lasts beyond a few days, symptoms worsen, or you develop breathlessness, confusion,
severe headache, or repeated vomiting.
Do all infections need antibiotics?
No. Antibiotics treat bacterial infections. Viral infections improve with rest, fluids, and supportive care.
What is antimicrobial stewardship?
Antimicrobial stewardship optimizes antibiotic use to improve patient outcomes, reduce resistance, and lower
healthcare costs through expert guidance, policies, audit, and education.
How long does recovery take?
Most infections improve within days to a week. Tiredness may linger; full strength returns gradually.
What are multidrug-resistant organisms?
MDROs are bacteria resistant to three or more antibiotic classes. Examples include MRSA and carbapenem-resistant
gram-negatives. They complicate treatment and require expert management.
Why are prosthetic joint infections difficult to treat?
Biofilms on implant surfaces protect bacteria from antibiotics and the immune system. Resistant organisms further
complicate therapy, requiring surgical intervention and prolonged antibiotic courses.
References
[1] CDC. Management of Multidrug-Resistant Organisms in Healthcare Settings (2006). [web:102]
[2] Infection Prevention and Control Measures for Multidrug-resistant Organisms. Infection. 2025;53:1158–1172. [web:104]
[3] Isler B, et al. Advancing the management of prosthetic joint infections. Orthop Rev (Pavia). 2025;17:12486824. [web:48]
[4] Preventing Periprosthetic Joint Infections: How to Lower Risk. AO Foundation. 2025. [web:109]
[5] Role of the Infectious Diseases Service in Antimicrobial Stewardship. Australian Commission on Safety and Quality in Health Care. [web:107]
[6] Infectious Diseases Physicians: Leading the Way in Antimicrobial Stewardship. Clin Infect Dis. 2018;66(7):995–1002. [web:110]
[7] Antimicrobial Stewardship With and Without Infectious Diseases Physician Leadership. Antibiotics. 2021;10(11):8576457. [web:112]
[8] Implementation and Core Elements of Antimicrobial Stewardship Programs. Glob Health Med. 2024;6(4):394–403. [web:114]
[9] Antimicrobial Stewardship. StatPearls [Internet]. NCBI Bookshelf; 2023. [web:116]
[10] Diagnosis and Management of Prosthetic Joint Infection. Clin Infect Dis. 2012;56(1):e1–e25. [web:111]
