Safety and Quality > Our Work > Healthcare Associated Infection > Antimicrobial Stewardship Initiative

Inappropriate and over use of antimicrobials contributes to the emergence of resistant bacteria and causes patient harm. Patients with antimicrobial-resistant infections are more likely to experience ineffective treatment, recurrent infection, delayed recovery or even death.

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). Along 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 aim of the Antimicrobial Stewardship Initiative is to improve the safe and appropriate use of antimicrobials, reduce patient harm and decrease the incidence of antimicrobial resistance in Australian hospitals.

NSQHS Standard 3

Standard 3 frontpage

Criterion: Antimicrobial Stewardship

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

From January 2013 health services are required to demonstrate they are meeting the requirements outlined in the NSQHS Standards in order to achieve accreditation. Safety and Quality Improvement Guides are available to assist health services implement each Standard including Standard 3 which contains a criterion on AMS. An accreditation workbook is also available.

Download the Safety and Quality Improvement Guide and Accreditation Workbook for Standard 3, Preventing and Controlling Healthcare Associated Infections.

FAQ Standard 3: Preventing and Controlling Healthcare Associated Infections – Antimicrobial Stewardship Criterion

The antimicrobial stewardship criterion requires that all healthcare services:

  • Have an antimicrobial stewardship program in place
  • Provide clinicians prescribing antimicrobials access to current endorsed Therapeutic Guidelines on antimicrobial usage
  • Undertake monitoring of antimicrobial  usage and resistance
  • Take action to improve the effectiveness of antimicrobial stewardship.

NSQHS Standard 3.16 specifies that Monitoring of antimicrobial usage and resistance is undertaken in eligible health services.


Antimicrobial Stewardship in Australian Health Care 2018

AMS book coverThis publication provides clinicians and health administrators with the evidence and requirements for hospital antimicrobial stewardship (AMS) programs.

It is available to download in full, or by chapter. The publication summarises current evidence about AMS strategies and interventions and their implementation



Antimicrobial Prescribing E-learning Modules

Learning module screenshotThe Commission and NPS MedicineWise have developed a series of e-learning modules on antimicrobial prescribing.

The modules are aimed at prescribers in their first 2 years out of medical school, as well as nurse practitioners, hospital pharmacists and university students. The modules address specific areas where antimicrobial use in hospitals is suboptimal. The modules can be accessed at


Antimicrobial Stewardship Video Presentations

The Commission  has prepared educational resources to support antimicrobial stewardship. Two new resources were released in 2014: recorded presentations from clinical experts with extensive knowledge and experience in this area. Dr Celia Cooper presents Think Global – Act Local –  a presentation concerning the problem of antimicrobial resistance and the role of antimicrobial stewardship in hospital settings in addressing antimicrobial resistance; and Miss Caroline Chen (Principles of antibiotic pharmacotherapy)  outlines different classes of commonly used antibiotics, their spectrum of activity and issues to consider when prescribing and administering these commonly used agents.

Antimicrobial Stewardship Video Presentations

National Antimicrobial Prescribing Survey (NAPS)

Monitoring the appropriateness of antimicrobial prescribing should be the ultimate aim of any AMS program. Data from prescribing surveys can be used to monitor effectiveness of interventions and establish priorities for improvement. To coincide with  Antibiotic Awareness Week 2013 the Melbourne Health NH&MRC Antimicrobial Stewardship research team coordinated the National Antimicrobial Prescribing Survey (NAPS). This work was supported by the Commission. Registration to the NAPS remains open.

More information about NAPS

Monitoring usage and resistance

Monitoring usage and resistance is important for measuring the effects of stewardship interventions and understanding local antimicrobial resistance patterns, and are key requirements of an AMS program.

NSQHS Standard 3.16 specifies that Monitoring of antimicrobial usage and resistance is undertaken in eligible health services.

Links to tools for monitoring usage