Antimicrobial stewardship includes the range of activities that promote, and support, optimal antimicrobial prescribing and use. The aim of the Commission’s work on antimicrobial stewardship is to improve the safe and appropriate use of antimicrobials, reduce patient harm and prevent and contain antimicrobial resistance in Australia.
Inappropriate use, and overuse, of antimicrobials contributes to an increase in resistant bacteria and may result in patient harm. Patients with antimicrobial-resistant infections are more likely to experience ineffective treatment, recurrent infection, delayed recovery, or even death. Recent data published by the Commission in AURA 2021 shows continuing and concerning patterns of antimicrobial use in Australia.
Antimicrobial stewardship (AMS) programs have been shown to decrease inappropriate antimicrobial usage, improve patient outcomes and reduce adverse consequences of antimicrobial use (including antimicrobial resistance, toxicity and unnecessary costs). Together with infection prevention and control, hand hygiene and surveillance, antimicrobial stewardship is considered a key strategy in local and national programs to prevent the emergence of antimicrobial resistance and decrease preventable healthcare associated infection.
The Preventing and Controlling Infections Standard requires all health service organisations to have an AMS program that:
- Includes an antimicrobial stewardship policy
- Provides access to, and promotes the use of, current evidence-based Australian therapeutic guidelines and resources on antimicrobial prescribing
- Has an antimicrobial formulary that includes restriction rules and approval processes
- Incorporates core elements, recommendations and principles from the current Antimicrobial Stewardship Clinical Care Standard
- Reviews antimicrobial prescribing and use
- Uses surveillance data on antimicrobial resistance and use to support appropriate prescribing
- Evaluates performance of the program, identify areas for improvement, and take action to improve the appropriateness of antimicrobial prescribing and use
- Reports to clinicians and the governing body regarding
- compliance with the antimicrobial stewardship policy
- antimicrobial use and resistance
- appropriateness of prescribing and compliance with current evidence-based Australian therapeutic guidelines or resources on antimicrobial prescribing.
The Commission has developed a number of resources to support health service organisations to meet the antimicrobial stewardship requirements of the National Safety and Quality Health Service Standards and the National Safety and Quality Primary and Community Healthcare Standards. These resources are designed to assist health organisations, their workforce and their consumers in implementing effective antimicrobial stewardship practices.
Antimicrobial Stewardship in Australian Health Care
The Commission’s Antimicrobial Stewardship in Australian Health Care (AMS Book) was first published in 2018, and continues to be enhanced with additional chapters to support antimicrobial stewardship (AMS) in specific settings. New chapters, and the addition of new resources are added to the AMS Book as hyperlinks. The latest chapter is 'Antimicrobial stewardship in dental practice'.
Surveillance of antimicrobial use
The Commission established and has continued to enhance the Antimicrobial Use and Resistance in Australia (AURA) Surveillance System to report on data on antimicrobial use and resistance in Australia. The surveillance programs that contribute antimicrobial use data to AURA include the National Antimicrobial Prescribing Survey (NAPS) and the National Antimicrobial Utilisation Surveillance Program (NAUSP).
The most recent data on antimicrobial use in Australia are available in AURA 2021: Fourth Australian report on antimicrobial use and resistance in human health.
A range of companion resources are also available for AURA 2021.
Antimicrobial Stewardship Advisory Committee
The roles of the AMS Advisory Committee include to:
- Provide support and advice in the implementation of the Commission’s Work Plan, in relation to AMS, as requested by the Commission. This includes advice on the development and review of Commission guidance and resources.
- Provide advice on resources to support the implementation and compliance with of the National Safety and Quality Health Service (NSQHS) Standards (second edition), in particular the Preventing and Controlling Healthcare-Associated Infection Standard, and other resources such as the review of Antimicrobial Stewardship in Australian Health Care 2018.
- Consider data and AURA Surveillance System reports to inform the provision of advice on effective AMS strategies across all sectors of healthcare to promote improve to patient care. This would include opportunities to promote consistency of approach to AMS surveillance and implementation.
- Promote the optimal use of antimicrobials to maximise treatment efficacy in individuals, while minimising the impact of AMR on communities.
- Advise the Commission on implementation aspects of AMS programs at local and jurisdictional levels; including opportunities for the Commission to engage with clinicians and consumers to seek feedback on enhancement of AMS programs.
- Consider strategies that will positively impact on, and engage with consumers in, their role in appropriate use of antimicrobials.
- Provide opportunity for sharing data and information on policies and processes, professional issues for the continual improvement of AMS.
- Provide the opportunity for members bring attention to issues which the Commission could respond to, to enhance AMS.
Committee members for 2020-2023 are:
- Professor John Turnidge AO (Chair)
- Professor Kirsty Buising
- Dr Jonathan Dartnell
- Dr Kathryn Daveson
- Ms Susannah Ford
- Associate Professor Thomas Gottlieb
- Dr David Kong
- Ms Nadine Hillock
- Dr Harvey Lander
- Dr Brendan McMullan
- Adjunct Professor Kathy Meleady PSM
- Dr Alison Ratcliff
- Associate Professor James (Owen) Robinson
- Professor Karin Thursky
- Dr Morgyn Warner
- Dr Trent Yarwood