Antimicrobial Stewardship in Australian Health Care

The AMS Book describes processes for the establishment and implementation of AMS programs, as well as promoting the role of all those involved in providing and receiving health care. This includes prescribers, pharmacists, infection control practitioners, nurses and midwives, consumers, and health service managers. The AMS Book summarises current evidence about AMS strategies and interventions, and their implementation. Each chapter provides a summary of the key points and contains resources relevant to each service type.

• Chapters 1–7 provide strategies for establishing, implementing, and sustaining AMS; developing strategies and interventions that enhance prescribing behaviour; use of electronic clinical decision support systems; clinician education; monitoring antimicrobial use and evaluation of program outcomes; and strategies for engaging consumers in AMS.
• Chapters 8–12 examine the roles of the range of clinicians involved in AMS. These chapters focus on the roles and responsibilities of clinicians in formal AMS programs, as well as how clinicians can incorporate AMS principles into their clinical practice. Clinicians covered in these chapters include infectious diseases physicians; clinical microbiologists; other prescribers; pharmacists; nurses and midwives; and infection control practitioners.
• Chapters 13 and beyond have been progressively published on this website, and include consideration of AMS matters across a range of settings.
• Chapters 13 consider AMS in the setting of general practice, covering antimicrobial resistance and antimicrobial use in the community; factors that influence antimicrobial prescribing in general practice; antimicrobial stewardship strategies for general practice; clinical governance; and leadership.
• Chapter 14 focuses on AMS in the care of children and the specific and important considerations for this population group.
• Chapter 15 focuses on AMS in Aboriginal and Torres Strait Islander peoples. This chapter indicates the infectious diseases and antimicrobial resistance experience of these communities; requirements of the NSQHS Standards regarding cultural awareness and cultural safety; and how AMS strategies can be optimised to support Aboriginal and Torres Strait Islander peoples.
• Chapter 16 focuses on antimicrobial use and appropriateness of use in the community and in residential aged care. The chapter discusses infections experienced by older people, strategies to improve antimicrobial use, and considers the barriers to the implementation of these strategies.  
• Chapter 17 highlights antimicrobial use and appropriateness of use in rural and remote hospitals and health services. The chapter describes issues affecting AMS in rural and remote hospitals and health services, identifies resources to support appropriate prescribing of antimicrobials, and practical strategies to improve AMS activities.
• Chapter 18 focuses on antimicrobial use and appropriateness in dental practice. The chapter describes current data on antimicrobial use in dental practice, AMS program strategies for dental settings, and approaches to managing and preventing infections in dental care.
• Chapter 19 focuses on antimicrobial use and appropriateness of use in private hospitals. The chapter describes how to engage prescribers including VMOs, working in a multidisciplinary team, specific AMS issues encountered in the private health sector and considers implementation strategies and possible barriers encountered in private hospitals.
• Chapter 20 focuses on outpatient antimicrobial use and appropriateness of use in hospital in the home and other settings. The chapter describes the importance of governance, partnering with consumers, the role of a multidisciplinary team for service delivery and considerations for de-escalation of therapy and transitions of care.