The Kerala government has introduced guidelines for an "Antibiotic-Smart" certification system for hospitals and local self-governments (LSGs) to combat antimicrobial resistance (AMR). This initiative, part of the "Antibiotic Literate Kerala" framework, aims to accredit institutions based on key performance indicators related to antimicrobial stewardship and infection control. The system includes certifications for Antibiotic Smart Hospitals, Antimicrobial Stewardship-Compliant Hospitals, and Antibiotic Literate LSGs, extending AMR awareness to the grassroots level.