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iii. AMS Actions / Interventions

Introduction

AMS interventions should begin in a stepwise build on existing systems and available data
and encourage participation of clinical staff and prescribers. Start with a simple intervention
on a small scale and keep it doable.

Below are the steps for AMS actions. It involves monitoring, surveillance and audit of antibiotic
utilisation.

Step 1 Identify areas for improvement based on available data such as
• Antimicrobial utilisation data.
• Rates of resistance among common pathogens.
• Assessing current prescribing practices (e.g. from point prevalence
survey, audits etc.) (Refer Table 1.)

Step 2 Develop and implement targeted AMS interventions based on the identified
areas of concern in step 1. Choose specific location (e.g. wards or unit) or
disease condition or specific antibiotic where it is feasible to intervene.

Involve stakeholders (prescribers) in the development of intervention
programme to enhance sustainability.

Determine the outcome and process measures that will be used to monitor
effectiveness of the intervention.
(Refer to section A.3)

Step 3 Assess the effectiveness of interventions and decide if further action needs
to be taken based on the target set.

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