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Step 3 - Assess the effectiveness of interventions

Once AMS interventions have been implemented or performed, analyse and present changes
made (with the respective unit, if applicable). Discuss whether the interventions should be
continued or changed and follow up with a continuous improvement cycle i.e. Plan-Do-Study-
Act.

Tips to run AMS activities for small hospital and limited resources

Studies have demonstrated a number of interventions to improve antibiotic use for each of
these three disease conditions; community- acquired pneumonia (CAP), urinary tract infection
(UTI) and skin and soft tissue infection (SSTI). Hence, these are often high-yield targets for
improvement.

Key opportunities to improve antimicrobial usage:

Assess duration of
Diagnostic Guide empiric
considerations therapy therapy including
discharge prescription

CAP Review cases at 48 Avoid empiric use of Uncomplicated
hours to confirm antipseudomonal beta- pneumonia can be
pneumonia diagnosis lactams and/or treated for 5-7 days in
versus non-infectious methicillin-resistant the setting of timely
etiology. Staphylococcus aureus appropriate clinical
(MRSA) agents unless response.
clinically indicated.

UTI Implement criteria to Establish Use the shortest
ensure urine culture checklist/criteria to duration for antibiotic
sent for those clinically distinguish therapy where
indicated. asymptomatic/ clinically appropriate.
symptomatic bacteriuria.
Avoid antibiotic therapy
for asymptomatic
bacteriuria except for
certain clinical
conditions.

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