Cardiovascular Infections and Stewardship Practices – A Call for Action to a Cardiologist and Cardiac Surgeon (A HEART AMSP Model)

Cardiovascular infections represent a critical interface between infectious diseases and cardiology. Infective endocarditis, cardiac device-related infections, vascular graft infections, postoperative mediastinitis, and infective complications of rheumatic and congenital heart disease contribute substantially to morbidity, mortality, and healthcare costs. These conditions also drive antimicrobial resistance (AMR) through empirical broad-spectrum therapy, prolonged antimicrobial exposure, and inconsistent adherence to diagnostic and preventive strategies. The 42 practice points of the Society of Antimicrobial Stewardship PractIces (SASPI) in India provide an actionable framework for integrating antimicrobial stewardship (AMS) into cardiovascular medicine and surgery. This editorial highlights stewardship challenges, defines the role of cardiologists and cardiac surgeons in combating AMR, and translates SASPI recommendations into practical clinical strategies. Key priorities include culture-guided therapy, optimized perioperative prophylaxis, timely source control including device or graft removal, catheter-care bundles, outpatient parenteral antimicrobial therapy, and integration of cardiac teams into institutional AMS programs (A HEART AMSP model).