How to start an antimicrobial stewardship programme in a hospital

Marc Mendelson, Andrew M Morris, Karin Thursky, CĂ©line Pulcini
Clinical Microbiology and Infection 2019 August 21

BACKGROUND: Antimicrobial stewardship (AMS) describes a coherent set of actions that ensure optimal use of antimicrobials to improve patient outcomes, while limiting 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 antimicrobial stewardship programme in their hospital, the components of such a programme, and the evidence base for its implementation.

SOURCES: National and society-led guidelines on antimicrobial stewardship, peer-reviewed publications, and experience of antimicrobial stewardship experts conducting antimicrobial stewardship programmes.

CONTENT: We provide a step-by-step pragmatic guide to setting up and implementing a hospital antimicrobial stewardship 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 antimicrobial resistance, 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 antimicrobial stewardship programme will help health care professionals involved in AMS to optimally design and implement their actions.


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