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How to start an antimicrobial stewardship programme in a hospital
M Mendelson1, A M Morris2, K Thursky3
1Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Background:
Antimicrobial stewardship (AMS) describes a coherent set of actions that ensure optimal use of antimicrobials to improve patient outcomes, while limiting the risk of adverse events (including antimicrobial resistance (AMR)). Introduction of AMS programmes in hospitals is part of most national action plans to mitigate AMR, yet the optimal components and actions of such a programme remain undetermined.
Objectives:
To describe how health-care professionals can start an AMS programme in their hospital, the components of such a programme and the evidence base for its implementation.
Sources:
National and society-led guidelines on AMS, peer-reviewed publications and experience of AMS experts conducting AMS programmes.
Content:
We provide a step-by-step pragmatic guide to setting up and implementing a hospital AMS programme in high-income or low-and-middle-income countries.
Implications:
Antimicrobial stewardship programmes in hospitals are a vital component of national action plans for AMR, and have been shown to significantly reduce AMR, particularly when coupled with infection prevention and control interventions. This step-by-step guide of 'how to' set up an AMS programme will help health-care professionals involved in AMS to optimally design and implement their actions.
Insights
This guide provides a step-by-step approach for healthcare professionals to establish hospital antimicrobial stewardship (AMS) programs. Implementing AMS programs is crucial for optimizing antimicrobial use and combating antimicrobial resistance (AMR).
Area of Science:
- Healthcare Management
- Infectious Disease Control
- Public Health Policy
Background:
- Antimicrobial stewardship (AMS) programs are essential for optimizing antimicrobial use and improving patient outcomes.
- These programs aim to mitigate adverse events, including antimicrobial resistance (AMR).
- Hospital AMS programs are a key component of national strategies to combat AMR, though optimal implementation remains under investigation.
Purpose of the Study:
- To provide a practical, step-by-step guide for healthcare professionals on initiating and implementing hospital AMS programs.
- To outline the essential components of an effective AMS program.
- To present the evidence supporting the implementation of AMS initiatives.
Main Methods:
- A review of national and society-led guidelines on antimicrobial stewardship.
- Analysis of peer-reviewed publications relevant to AMS programs.
- Incorporation of practical experience from AMS experts in program implementation.
Main Results:
- The study offers a pragmatic, step-by-step framework for establishing hospital AMS programs.
- The guide is applicable to both high-income and low-and-middle-income countries.
- It details the necessary components and evidence base for successful AMS program implementation.
Conclusions:
- Hospital AMS programs are critical for national action plans against AMR.
- Effective AMS programs, especially when combined with infection prevention and control, significantly reduce AMR.
- This guide empowers healthcare professionals to design and implement optimal AMS strategies.
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