Key components of antimicrobial stewardship

Governance systems and policies to support Antimicrobial Stewardship (AMS)

The South Australian expert Advisory Group on Antimicrobial Resistance (SAAGAR) is the peak governance committee for antimicrobial stewardship in South Australia.

The ACSQHC has developed resources for AMS which are useful in establishing and evaluating AMS systems within Australian health facilities.

This WHO policy guidance published in 2021 includes the principles of antimicrobial stewardship and details on strategies on implementing interventions to optimise antimicrobial use. 

Antimicrobial formulary management

The South Australian Formulary Committee (SAFC) has completed the anti-infective section of the South Australian Medicines Formulary. A consultative and evidence based medicine approach is used to maintain a list of antimicrobials that are available for use in SA Health facilities. Antimicrobials for which there is increased concern regarding the development of resistance are further restricted via systems within LHNs, to enable timely, expert intervention by Infectious Diseases specialists.

Guidelines on antimicrobial usage

The Therapeutic Guidelines: Antibiotic is the primary evidence-based reference for the treatment of infectious diseases in SA Health facilities. Prescribers and clinical staff can access this guideline via their LHN intranet, or via the SA Health library (SALUS).

At a state level, SAAGAR prepares and reviews clinical guidelines on relevant antimicrobial topics for use in SA Health facilities. These guidelines are available on the Antimicrobial Guidelines web page. Localised guidelines are also available within each Local Health Network.

Education and feedback to the clinical workforce

Safe and appropriate use of antimicrobials requires a clinical workforce with adequate knowledge and skills relating to the management of infectious diseases and antimicrobial stewardship principles. Clinical education programs for prescribers, pharmacists and nurses within our health facilities incorporate these concepts. The National Prescribing Service (NPS) has developed a series of online training modules which prescribers and pharmacists are encouraged to incorporate as part of their continuing professional development learning plans.

Surveillance of antimicrobial usage and resistance

Understanding patterns of antimicrobial usage through various surveillance and auditing methods enables investigation of changes in utilisation and prescribing practices, and helps to target interventions to improve antimicrobial stewardship. Major SA Health facilities (metropolitan and regional) contribute to the National Antimicrobial Utilisation Surveillance Program (NAUSP) which provides standardised antimicrobial consumption data to hospital administrators and clinical staff.

See the Antimicrobial Utilisation Reports page for the latest state and national NAUSP reports.

Alternative methods for more in depth and targeted evaluation of antimicrobial prescribing include point prevalence surveys and clinical audits, such as the National Antimicrobial Prescribing Survey (NAPS). For further information on NAPS see the National Antimicrobial Prescribing Survey website.

Consumer resources related to antimicrobial stewardship

Antimicrobial Awareness Week is an international initiative occurring in November each year to highlight the threat of widespread antimicrobial resistance. It is a campaign directed towards consumers, professionals and government leaders to promote the importance of antimicrobials to healthcare and awareness of the risks associated with their inappropriate use.

The NPS has a number of resources for consumers and health professionals to support the appropriate use of antibiotics.

The ASCQHC launched Clinical Care Standards for AMS in November 2014. A consumer fact sheet details when the use of antibiotics and microbiological testing is appropriate, and ensures patients receive suitable information regarding their treatment options.

Further information

For further information on antimicrobial stewardship contact