Levels of ASP
macro (national), meso (regional/ cluster/ hosp) and micro level (patient, clinician)
Aims of antimicrobial stewardship program
- Optimise clinical outcome
- Minimise toxicity, selection of microorganisms and emergence of resistance
- Reduce healthcare cost w/o adversely impacting quality of care
Core elements of an antimicrobial stewardship program
- Leadership commitment
- AMS actions
- Monitoring & surveillance
- Education & training
- Accountability & responsibilities
- Reporting & feedback
Strategies employed in an antimicrobial stewardship program
- Education
- Surveillance and Risk Assessment
- Research
- Prevention and Control of Infection and
- Optimisation of Antimicrobial Use
Three priority ASP interventions
- Formulary restriction and pre-authorisation
- Prospective audit and feedback
- Facility-specific evidence-based treatment guidelines
pros and cons of Prospective audit and feedback
Pros:
* Provides more clinical data to enhance uptake of recommendations
* Gives greater flexibility in timing of interventions
* Can address duration of therapy
Cons
* Impacts use of audited agents only
* Recommended action generally optional and may not be followed
Utility of point prevalence survey in antimicrobial stewardship
Provide regular updates
Report include process and outcome measures that address both national and local issues
Share areas of improvement and areas for further improvement
Accountability to institution leadership and stakeholders
Justification for further funding
Keep stakeholders and leadership informed of work done ASP
Keep stakeholders reminded and engaged in antimicrobial stewardship
