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A.2 ANTIMICROBIAL STEWARDSHIP ACTIVITIES

i. General Overview

The core elements below need to be in place prior to start antimicrobial stewardship activities:

CORE ELEMENTS

1 Governance structure

2 Formulation of hospital antimicrobial policy
(Refer to General Policies - Development and documentation of local antimicrobial
policy)

3 Establishment of AMS team

4 Hospital-endorsed guideline (preferably based on local antimicrobial guideline e.g.
National Antimicrobial Guideline (NAG)

5 Assessment of current practice and available resources
• Antimicrobial utilisation data (e.g. defined-daily dose (DDD), Days of
therapy (DOT) of selected antimicrobial, trending antimicrobial use)
• Rates of resistance among common pathogens

6 Identify areas of intervention
• Specific location (e.g. medical wards or ICU)
• Specific disease conditions (e.g. Pneumonia, UTI)
• Specific antimicrobial ( e.g. Broad-spectrum antimicrobial (carbapenem),
High usage of specific antimicrobial (vancomycin))

7 Development and implementation of effective strategies to address any
inappropriate antimicrobial usage

8 Regular educational and awareness programme related to AMR & AMS

26 Protocol on Antimicrobial Stewardship (AMS) Programme in Healthcare Facilities | Second Edition 2022