Info for consumers - Antimicrobial Stewardship Clinical Care Standard

What the standard says

A patient with a life-threatening condition due to a suspected infection receives an appropriate antimicrobial immediately, without waiting for the results of investigations. 

What this means for you 

Infections can be serious and may be life threatening. Examples of these conditions include:   

• Sepsis (when the body’s response to an infection injures its own tissues and organs)     
• Meningitis (an infection of the tissues lining the brain)     
• Necrotising fasciitis (a serious infection from a flesh-eating bacteria).

If you are unwell with a serious infection, you will be given appropriate medicine to treat the infection without delay.

What the standard says

When a patient is prescribed an antimicrobial, this is done in accordance with the current Therapeutic Guidelines or evidence-based, locally endorsed guidelines and the antimicrobial formulary.

What this means for you

If you are prescribed a medicine for an infection, your clinician will discuss which medicine is best for you, based on national or local recommendations. Your clinician should also consider any allergies and other health conditions you may have, as well as the cause of your infection.

What the standard says

When an adverse reaction (including an allergy) to an antimicrobial is reported by a patient or recorded in their healthcare record, the active ingredient(s), date, nature and severity of the reaction are assessed and documented. This enables the most appropriate antimicrobial to be used when required.

What it means to you 

Adverse reactions are any unwanted effects of a medicine. Many adverse reactions are expected side effects of medicines, and can range from mild to severe. An ‘allergic reaction’ is one type of adverse reaction.

If you have ever had an unwanted response to a medicine used to treat an infection, even if it was many years ago, talk to your clinician. They will ask you about what happened to find out whether it was because of the medicine, how severe it was and what it means for your care. As a result, your treatment may change and your healthcare record will be updated. Important changes will be communicated to you and your regular doctor.

If you have had an adverse reaction to a medicine, it is important that this information is added to your healthcare record. You can also review and update your information in your My Health Record. Carry a list of your medicines with you, and make sure that it includes the most up-to-date information about your previous adverse reactions to medicines, including allergies.

What the standard says

A patient with a suspected infection has appropriate samples taken for microbiology testing as clinically indicated, preferably before starting antimicrobial therapy. 

What it means for you 

Before you are given medicines to treat an infection, your clinician will try to find out what is causing the infection. This will help them to decide which medicine is best for you. You may need to have a sample taken – for example, from your blood (a blood test), urine (a urine test) or a wound (wound swab) to find out what kind of microbe (sometimes known as a bug) is causing the infection. It may be important to start treating the infection straight away, before you have the test results. However, your medicine can be changed later if needed.

What the standard says

A patient with an infection, or at risk of an infection, is provided with information about their condition and treatment options in a way that they can understand. If antimicrobials are prescribed, information on how to use them, when to stop, potential side effects and a review plan is discussed with the patient.

What it means for you

If you have an infection, or are at risk of developing an infection, your clinician will talk to you about your treatment options. This may mean taking medicines depending on the type or risk of infection you have. Your clinician will explain the possible benefits and harms (the good things and bad things) that might happen.

If you decide to take the medicine, your clinician will give you instructions about what you need to do. It is important that you follow these instructions correctly so that the medicine can work to fight your infection. Talk to your clinician if you are not sure what do, or if you have questions.

Some medicines may have side effects. Understanding the possible side effects can help you know what to expect.

Some other things that you need to know about the antimicrobial medicine are:    

• When to start the medicine     
• How many times a day to take, use or apply the medicine     
• Whether to take tablets or capsules with food or on an empty stomach    
• How the medicine will affect other medicines you use    
• What the potential side effects are    
• Signs or symptoms of when to seek urgent care, depending on the type or risk of infection
• When to stop the medicine.

You may need another appointment with your clinician to check that the medicine is working.

What the standard says

When a patient is prescribed an antimicrobial, the indication, active ingredient, dose, frequency and route of administration, and the intended duration or review plan are documented in the patient’s healthcare record. 

What it means for you

Your healthcare record contains information about your antimicrobial therapy. This includes information on:    

• The medicines you have been prescribed (active ingredients)    
• Why they were prescribed and by whom    
• When they were prescribed    
• The dose    
• What form of the medicine you use (such as tablets or an injection)    
• How often you have them    
• How long to use them for     
• Any plans to review your treatment. 

What the standard says

A patient prescribed an antimicrobial has regular clinical review of their therapy, with the frequency of review dependent on patient acuity and risk factors. The need for ongoing antimicrobial use, appropriate microbial spectrum of activity, dose, frequency and route of administration are assessed and adjusted accordingly. Investigation results are reviewed promptly when they are reported.

What it means for you

If you are prescribed a medicine for an infection, your clinician should regularly check that you still need the medicine and that it’s the best medicine for you. If tests have been done to find out what kind of infection you have, your clinician should review these results as soon as they are available. When your infection has improved, it may be appropriate to stop or change how you use this medicine (for example, changing from an injection, infusion or drip to a medicine you take by mouth).

If the cause of your infection is unclear, you may be prescribed a medicine that works against different types of infections. You may need to have tests (such as a blood or urine test) to check if the medicine is working. Depending on the test results, your treatment may need to continue, change or stop. 

What the standard says

A patient having surgery or a procedure is prescribed antimicrobial prophylaxis in accordance with the current Therapeutic Guidelines or evidence-based, locally endorsed guidelines. This includes recommendations about the need for prophylaxis, choice of antimicrobial, dose, route and timing of administration, and duration.

What it means for you

Before a surgical procedure, medicines may be given to you to reduce the risk of an infection. The prescription will be based on national or local recommendations. After having a surgical procedure, antimicrobials are not usually needed unless you have an infection.