Antimicrobial stewardship

Safe and appropriate antimicrobial prescribing is a strategic goal of the clinical governance system.

Antimicrobial stewardship (AMS) is defined as an ongoing effort by a health service organisation to optimise antimicrobial use among patients ‘to improve patient outcomes, ensure cost-effective therapy and reduce adverse sequelae of antimicrobial use (including antimicrobial resistance). An AMS program involves strategies and interventions that aim to reduce unnecessary antimicrobial use and promote the use of agents that are less likely to select for resistant microorganisms. This is done in line with treatment guidelines and with consideration of local susceptibility patterns.

Effective AMS programs reduce inappropriate antimicrobial use, improve patient outcomes and reduce adverse consequences of antimicrobial use (including antimicrobial resistance, toxicity and unnecessary costs). Along with infection prevention and control, hand hygiene and surveillance, AMS programs are a key strategy in preventing antimicrobial resistance and decreasing preventable infections. The emergence of antimicrobial-resistant bacteria is closely linked with inappropriate antimicrobial use.

The intent of this criterion is to ensure appropriate prescribing of antimicrobials, as part of the broader systems within a health service organisation to prevent and manage infections and improve patient safety and quality of care.

This criterion, and the actions and strategies outlined in this guide should be considered in conjunction with the requirements of the Medication Safety Standard.

The content and implementation strategies for this criterion have been drawn from Antimicrobial Stewardship in Australian Hospitals, which summarises the evidence about AMS programs, and details strategies for implementing and sustaining these programs. It is recommended that health service organisations consult this publication when planning and implementing an AMS program.

AMS programs may need to be tailored in each organisation. The types of strategies and activities used depend on the specific organisational context, and factors such as the complexity, size and resources available for implementation, monitoring and evaluation.

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