Antimicrobial Stewardship Policy
PDF 412 KB
The policy is to establish the basis for antimicrobial stewardship (AMS) within SA Health.
The South Australian expert Advisory Group on Antimicrobial Resistance (SAAGAR) has developed evidence-based, peer-reviewed guidelines relating to best practice standards in antimicrobial usage. By optimising use of antimicrobials, adverse events including the development of antimicrobial resistance can be minimised.
These guidelines are designed to be used in conjunction with Therapeutic Guidelines: Antibiotic Version 16 developed by Therapeutic Guidelines Limited (TGL), an independent not-for-profit organisation.
Further guidelines will be added to this site as they become available.
A national COVID-19 Clinical Evidence Taskforce has been established to undertake continuous evidence surveillance and synthesis to provide national, evidence-based guidelines for the clinical care of patients with COVID-19. These 'living' guidelines are continually updated weekly.
Some LHN's have developed their own guidelines for disease-modifying treatments or antivirals for patients with COVID-19 — please contact the respective ID teams. Clinical flow charts developed by the National Taskforce are available here.
Surgical antimicrobial prophylaxis is an accepted part of surgical practice to prevent infections at the surgical site and optimise post-operative recovery. The statewide Surgical Antimicrobial Prophylaxis Clinical Guideline (PDF 864KB) has been developed by SAAGAR to assist clinicians with recommendations on appropriate antibiotic dosage and administration, risks and contraindications and post-operative care for a range of surgical procedures.
The recommended antimicrobial prophylaxis regimens for specific surgical procedures, along with alternatives for patients with a high risk of penicillin/cephalosporin allergy, are available in the Surgical Antimicrobial Prophylaxis Clinical Guideline (PDF 864KB) appendices 1 to 17.
Individual appendices are available here:
Aminoglycosides: recommendations for use, dosing and monitoring (PDF 152KB) - prescribing guideline for the safe and effective use of aminoglycoside antibiotics.
Antimicrobial prescribing clinical guideline (PDF 356KB) – provides general principles when prescribing antimicrobials for patients with, or risk of, infection.
Community acquired pneumonia (adults) management clinical guideline (PDF 275KB) – provides advice to assist prescribers to identify and initiate empirical antimicrobial therapy for suspected community acquired pneumonia (CAP) in adult patients.
Diabetic foot infections antibiotic management clinical guideline (PDF 1.16MB) - provides advice on the appropriate empiric antimicrobial treatment based on the assessment of the severity of foot infections and the likely pathogens involved.
Febrile neutropenia management (adults) clinical guideline (PDF 313KB) – provides advice on the best practice in the initial management of febrile neutropenia in adult patients. The febrile neutropenia emergency letter (PDF 176KB) provides instruction for prompt assessment and treatment of patients at risk.
Hospital-acquired Pneumonia and Ventilator-associated Pneumonia (Adults) Clinical Guideline (PDF 733KB) - guide the management of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP.)
Intravenous to oral switch clinical guideline for adult patients – can antibiotics S.T.O.P. (PDF 175KB) – provides recommendations for the appropriate and timely switching of intravenous antimicrobials to an oral equivalent.
Splenectomy Vaccination and Antimicrobial Prophylaxis (Adult Asplenic and Hyposplenic Patients) Clinical guideline (PDF 817KB) and The SA Health Post-splenectomy treatment consumer information (PDF 322KB) – provides recommendations for the care of patients in order to protect them from overwhelming post-splenectomy infections (OPSI).
Staphylococcus aureus bacteraemia (SAB) management (adult) clinical guideline (PDF 363KB) - to assist decision making around antimicrobial prescribing, investigations and duration of therapy.
Urinary Tract Infections (adult): empirical treatment clinical guideline (PDF 301KB) – provides advice on the initial empirical antimicrobial therapy for urinary tract infections in adult patients. See Appendix 4: When to screen and treat asymptomatic bacteriuria in adults (PDF 78KB) for further guidance on asymptomatic bacteriuria. For treatment of UTI's in pregnancy, visit the S.A Health Perinatal Practice Guideline page. For Urinary Tract Infection (UTI) in children visit the Paediatric Clinical Practice Guidelines page.
Vancomycin dosing and monitoring clinical practice guideline (PDF 379KB) - provides statewide directive on the safe and effective use of vancomycin in adults.
Sepsis: SA Health's web page Sepsis for Health Professionals has important information regarding the recognition of the signs of Sepsis. The Sepsis Clinical Care Standard (2022) aims to support improvements in the delivery of sepsis care in healthcare services.
The AMS committee at Women's and Children's Hospital have developed a number of prescribing guidelines and resources for paediatric patients. For access to these resources please contact SA Health's Antimicrobial Programs team.
[Note SA Health employees can access these resources through the Women's and Children's Hospital Intranet site].
For information regarding antibiotic allergies; including choosing the appropriate antibiotic for a patient with a history of antibiotic allergy plus how an antibiotic allergy should be recorded in patient notes visit the Antibiotic Allergies page.
For further information on antimicrobial guidelines contact HealthAntibio@sa.gov.au