How to implement an antibiotic stewardship program

Caroline Chen1, Dr Rodney James1 ,A/Prof Noleen Bennett1,2, A/Prof  Kirsty Buising1

1National Centre for Antimicrobial Stewardship, Melbourne, Australia

2Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Melbourne, Australia

Antibiotics are amongst the most frequently prescribed medications in Australian aged care homes.  The most recent Aged Care National Antimicrobial Prescribing Survey found the prevalence of residents prescribed at least one antimicrobial was 9.9%. If all topical antimicrobials were excluded, the prevalence was 6.7%.

Antibiotic stewardship refers to a set of actions designed to reduce adverse events associated with antibiotic use. These adverse events can be especially significant for residents receiving care in aged care homes and include hypersensitivity reactions, drug toxicity, drug interactions and colonisation and/or infection with antibiotic resistant pathogens. For this reason, the new Aged Care Quality Standards aiming to promote optimal clinical care and reduce any adverse events require all Australian aged care homes to demonstrate implementation of an antibiotic stewardship program.

There is no single template for an antibiotic stewardship program in an Australian aged care home. The complexity of decision making surrounding antibiotic use and the variability in the size and type of these homes requires flexibility in implementation. That said, there are core elements (leadership commitment, accountability, drug expertise, action, tracking, reporting and education) that should be considered.

This workshop relates to the Summits’ sub-theme ‘Performance” and ‘Meeting the standards’.  Examples of how the core elements and recommended strategies of an antibiotic stewardship program can be easily applied in different Australian aged care homes will be provided. All administrative and clinical participants will be encouraged to implement at least two strategies to start with and once these are established to include new strategies.


Caroline Chen is an antimicrobial pharmacist at the National Centre for Antimicrobial Stewardship, and has previously held roles as the infectious diseases and antimicrobial stewardship pharmacists at the Royal Melbourne Hospital. She lead the establishment of the National Antimicrobial Prescribing Survey (NAPS) program and currently works in developing electronic decision support programs to support antimicrobial stewardship in hospitals.

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